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局部麻醉下改良莫根夹与经典背侧切开包皮环切术的比较:一项临床研究。

Comparison of a modified Mogen clamp and classic dorsal slit circumcision under local anesthesia: A clinical study.

作者信息

Güler Yavuz

机构信息

Department of Urology, Private Safa Hospital, Istanbul, Turkey.

出版信息

Curr Urol. 2022 Sep;16(3):175-179. doi: 10.1097/CU9.0000000000000083. Epub 2022 Aug 2.

Abstract

BACKGROUND

Currently, although various methods are used, there is no gold standard method for circumcision. Therefore, we developed a modified circumcision clamp inspired by the Mogen clamp suitable for circumcisions performed under local anesthesia in our country. To evaluate its success and complications, we compared our modified Mogen clamp with a dorsal slit circumcision.

MATERIALS AND METHODS

From 2013 to 2017, we retrospectively evaluated 1309 patients who had undergone circumcision; of these, 832 used the modified Mogen clamp method (Group 1) and 477 used the dorsal slit method (Group 2). The patients' age, surgery duration, minor hemorrhage (not requiring suture or repeated surgical exploration after circumcision but with buffer or clotting solution used), major hemorrhage (hemorrhage requiring suture or exploration), redundant prepuce skin remnants, revision numbers, and family satisfaction values were evaluated and compared between the 2 groups.

RESULTS

Patients were assessed at least 3 times: 1day, 1week, and 1month after circumcision. The mean ages in Groups 1 and 2 were 16.5±22.8 versus 15.5±18.8 months, respectively. The surgical procedure durations were 9.2±1.7 and 15.4±2.5 minutes in Groups 1 and 2, respectively ( < 0.001). Complications were found in 164 (19.7%) versus 81 patients (17.0%) ( = 0.522), including redundant skin in 42 (5.4%) versus 15 patients (3.14%) ( = 0.105) and major hemorrhage in 20 (2.4%) versus 15 patients (3.3%) ( = 0.230) in Groups 1 and 2, respectively.

CONCLUSION

Under local anesthesia, the circumcision procedure with the modified Mogen clamp can be performed more rapidly than with the dorsal slit, and the cosmetic results are better as the incision line is more regular. All postoperative complications were similar, with problems related to redundant skin occurring more frequently with clamp circumcision.

摘要

背景

目前,尽管使用了各种方法,但包皮环切术尚无金标准方法。因此,我们受莫根夹启发开发了一种改良的包皮环切夹,适用于我国在局部麻醉下进行的包皮环切术。为评估其成功率和并发症,我们将改良的莫根夹与背侧切开包皮环切术进行了比较。

材料与方法

2013年至2017年,我们回顾性评估了1309例接受包皮环切术的患者;其中,832例采用改良莫根夹法(第1组),477例采用背侧切开法(第2组)。对两组患者的年龄、手术时长、轻微出血(包皮环切术后无需缝合或再次手术探查,但使用了缓冲液或凝血溶液)、严重出血(需要缝合或探查的出血)、多余包皮皮肤残留、修复次数和家属满意度值进行了评估和比较。

结果

患者在包皮环切术后至少接受了3次评估:术后1天、1周和1个月。第1组和第2组的平均年龄分别为16.5±22.8个月和15.5±18.8个月。第1组和第2组的手术时长分别为9.2±1.7分钟和15.4±2.5分钟(<0.001)。第1组和第2组分别有164例(19.7%)和81例(17.0%)出现并发症(P = 0.522),包括多余皮肤,第1组有42例(5.4%),第2组有15例(3.14%)(P = 0.105);严重出血,第1组有20例(2.4%),第2组有15例(3.3%)(P = 0.230)。

结论

在局部麻醉下,使用改良莫根夹进行包皮环切术比背侧切开法更快,且由于切口线更规则,美容效果更好。所有术后并发症相似,夹法包皮环切术出现多余皮肤相关问题的频率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11e2/9527931/272e7e9beaaa/curr-urol-16-175-g001.jpg

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