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优化小儿包茎和包皮过长的治疗策略:传统包皮环切术与一次性包皮环切吻合器的对比研究

Optimizing treatment strategies for pediatric phimosis and redundant prepuce: a comparative study of traditional circumcision and disposable circumcision stapler.

作者信息

Zhang Guoyan, Luo Yongliang, Cheng Shangchao, Tu Yonglang, Meng Xiangyu, Wu Linde, Li Gang, Chen Xiyuan

机构信息

Physical examination and Rehabilitation Department, Kunming City Maternal and Child Health Hospital, Kunming, Yunnan, China.

Surgery, Yunnan Maternal and Child Health Hospital, Kunming, Yunnan, China.

出版信息

Front Pediatr. 2024 Jul 22;12:1394403. doi: 10.3389/fped.2024.1394403. eCollection 2024.

Abstract

OBJECTIVE

To investigate the surgical outcomes and complication rates of traditional circumcision and disposable circumcision stapler in the treatment of pediatric patients with phimosis and redundant prepuce.

METHODS

A retrospective analysis was conducted on pediatric patients with phimosis or preputial redundancy treated at our pediatric surgery department from January 2022 to December 2023. The patients were divided into two groups: treated with traditional circumcision (control group) and treated with a disposable circumcision stapler (experimental group). Surgical parameters (operation time, intraoperative bleeding), postoperative outcomes (postoperative pain scores, wound healing time, severe edge swelling, wound dehiscence, postoperative rebleeding, postoperative infection, aesthetic satisfaction), were compared between the two groups.

RESULTS

A total of 301 pediatric patients were included in our study, with 146 in the traditional group and 155 in the stapler group. The stapler group showed significantly lower values in operation time, intraoperative bleeding, and postoperative rebleeding compared to the traditional group ( < 0.05). However, the traditional group had a significant advantage in postoperative wound healing time and the occurrence of severe edge swelling ( < 0.05). There were no significant differences between the two groups in terms of anesthetic drug dosage, postoperative pain level, postoperative infection rate, wound dehiscence, and aesthetic satisfaction ( > 0.05).

CONCLUSION

In the treatment of pediatric phimosis and redundant prepuce, the advantage of traditional circumcision lies in faster postoperative recovery and less severe edge swelling. The disposable circumcision stapler excels in thorough hemostasis, easy and safe operation, suitable for primary medical use, but lags behind in postoperative recovery compared to the traditional method. Each treatment approach has its own advantages, and the choice should be based on the actual condition and circumstances of the patient. Personalized treatment decisions should be made collaboratively to achieve the best therapeutic outcomes.

摘要

目的

探讨传统包皮环切术与一次性包皮环切吻合器治疗小儿包茎及包皮过长的手术效果及并发症发生率。

方法

对2022年1月至2023年12月在我院小儿外科接受治疗的小儿包茎或包皮过长患者进行回顾性分析。将患者分为两组:传统包皮环切术治疗组(对照组)和一次性包皮环切吻合器治疗组(试验组)。比较两组的手术参数(手术时间、术中出血)、术后结果(术后疼痛评分、伤口愈合时间、切口严重肿胀、伤口裂开、术后再出血、术后感染、美观满意度)。

结果

本研究共纳入301例小儿患者,传统组146例,吻合器组155例。与传统组相比,吻合器组在手术时间、术中出血和术后再出血方面的值显著更低(<0.05)。然而,传统组在术后伤口愈合时间和切口严重肿胀的发生率方面具有显著优势(<0.05)。两组在麻醉药物用量、术后疼痛程度、术后感染率、伤口裂开和美观满意度方面无显著差异(>0.05)。

结论

在小儿包茎及包皮过长的治疗中,传统包皮环切术的优势在于术后恢复较快且切口严重肿胀较轻。一次性包皮环切吻合器在彻底止血、操作简便安全、适合基层医疗使用方面表现出色,但与传统方法相比,术后恢复滞后。每种治疗方法都有其自身的优势,应根据患者的实际情况和具体情形进行选择。应共同做出个性化的治疗决策,以实现最佳治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c46e/11298388/27d5a1f60081/fped-12-1394403-g001.jpg

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