[一次性包皮环切缝合器包皮环切术后系带过短：原因及手术方法改进]
[Abnormally short frenulum induced by circumcision with the disposable circumcision suture device: Causes and improvement of the surgical method].
作者信息
Shen Min-Qiang, Shi Tian-Li, Yang Rong-Hua
机构信息
Department of Urology, Huzhou Central Hospital, Huzhou, Zhejiang 313000, China.
Department of Urology, Central Hospital of Huzhou Normal College, Huzhou, Zhejiang 313000, China.
出版信息
Zhonghua Nan Ke Xue. 2020 Dec;26(12):1096-1110.
OBJECTIVE
To investigate the causes of abnormally short frenulum induced by circumcision with disposable circumcision suture device and the improvement of the surgical method.
METHODS
We retrospectively analyzed the clinical data on 320 cases of phimosis or redundant prepuce treated from January 2020 to September 2020, including 160 children (group A) and 160 adults (group B), each further divided into an observation group (n = 80, groups A1 and B1) and a control group (n = 80, groups A2 and B2). The patients in groups A1 and B1 underwent circumcision by suture positioning at the frenulum with the disposable circumcision suture device, and those in groups A2 and B2 received conventional circumcision with the disposable circumcision suture device. We compared the operation time, incidence rate of abnormally short frenulum and Visual Analogue Scale (VAS) score at 6 hours after surgery among the four groups of patients.
RESULTS
Statistically significant differences were observed between groups A1 and A2 in the operation time (12.00 ［11.00, 13.00］ vs 8.50 ［8.50, 9.00］ min, P < 0.05) and the incidence rate of abnormally short frenulum (0 vs 10%, P < 0.05) but not in the VAS score (3.00 ［3.00, 4.00］ vs 3.00 ［3.00, 3.75］, P > 0.05). Statistically significant differences were also found between groups B1 and B2 in the operation time (12.00 ［11.00, 12.00］ vs 6.25 ［6.00, 7.00］ min, P < 0.05) and the incidence rate of abnormally short frenulum (0 vs 7.5%, P < 0.05) but not in the VAS score (2.00 ［2.00, 3.00］ vs 2.00 ［2.00, 3.00］, P > 0.05).
CONCLUSIONS
Abnormally short frenulum induced by circumcision with the disposable circumcision suture device is mainly attributed to ligation and fixation of the prepuce with the fixation band. Circumcision with the disposable circumcision suture device by suture positioning at the frenulum is a safe and effective method worthy of clinical promotion.
目的
探讨一次性包皮环切缝合器包皮环切术后包皮系带过短的原因及手术方法的改进。
方法
回顾性分析2020年1月至2020年9月收治的320例包茎或包皮过长患者的临床资料，其中儿童160例（A组），成人160例（B组），每组再分为观察组（n = 80，A1组和B1组）和对照组（n = 80，A2组和B2组）。A1组和B1组患者采用一次性包皮环切缝合器在系带处缝合定位行包皮环切术，A2组和B2组患者采用一次性包皮环切缝合器行传统包皮环切术。比较四组患者的手术时间、包皮系带过短发生率及术后6小时视觉模拟评分（VAS）。
结果
A1组与A2组比较，手术时间（12.00［11.00，13.00］vs 8.50［8.50，9.00］min，P < 0.05）及包皮系带过短发生率（0 vs 10%，P < 0.05）差异有统计学意义，而VAS评分（3.00［3.00，4.00］vs 3.00［3.00，3.75］，P > 0.05）差异无统计学意义。B1组与B2组比较，手术时间（12.00［11.00，12.00］vs 6.25［6.00，7.00］min，P < 0.05）及包皮系带过短发生率（0 vs 7.5%，P < 0.05）差异有统计学意义，而VAS评分（2.00［2.00，3.00］vs 2.00［2.00，3.00］，P > 0.05）差异无统计学意义。
结论
一次性包皮环切缝合器包皮环切术后包皮系带过短主要与固定带结扎固定包皮有关。采用一次性包皮环切缝合器在系带处缝合定位行包皮环切术是一种安全有效的方法，值得临床推广。
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