Long Yan, Wang Tian-Chi, Wang Ke-Jian, Zhu Yong
Department of Andrology, Yancheng Traditional Chinese Medicine Hospital, The Affiliated Hospital of Nanjing University of Chinese Medicine, Yancheng, China.
Department of Urology, Binhai Traditional Chinese Medicine Hospital, Binhai, China.
Transl Androl Urol. 2025 Aug 30;14(8):2245-2253. doi: 10.21037/tau-2025-324. Epub 2025 Aug 25.
The disposable circumcision suture device (DCSD) faces significant limitations in anatomical adaptability. We developed a novel technique integrating the adjustable purse-string suture (APSS) from proctology to address this unmet need. This study aimed to evaluate the safety and feasibility of APSS-DCSD for circumcision.
A retrospective cohort study analyzed 93 consecutive patients undergoing circumcision (December 2023-January 2025). Non-randomized allocation stratified patients into: the APSS-DCSD cohort (n=45) and conventional DCSD cohort (n=48). Outcomes measure included operative time, blood loss, complications (frenular injury, infection), intraoperative pain (Visual Analogue Scale, VAS), patient satisfaction, and healing time.
No significant intergroup differences were observed in blood loss (median: 3.2 3.1 mL; P=0.66), healing time (median: 24 23 days; P=0.85), or VAS scores (median: 3.0 4.0; P=0.10). The APSS-DCSD cohort revealed longer operative times [7.0 6.5 min; 95% confidence interval (CI): 1.708-8.809; P<0.001] and significantly higher satisfaction (median score: 5 4; 95% CI: 3.414-20.995; P<0.001). Incision infections occurred in three cases overall (APSS-DCSD: 2.2% DCSD: 4.2%; P>0.99). No severe complications (hematoma, frenular injury) were documented in either cohort.
The APSS-DCSD approach significantly improves anatomical precision and patient satisfaction without compromising safety margins. Its standardized protocol demonstrates particular utility in complex anatomies, warranting prospective multicenter validation.
一次性包皮环切缝合器（DCSD）在解剖适应性方面存在显著局限性。我们开发了一种将直肠病学中的可调节荷包缝合术（APSS）整合进来的新技术，以满足这一未被满足的需求。本研究旨在评估APSS-DCSD用于包皮环切术的安全性和可行性。
一项回顾性队列研究分析了93例连续接受包皮环切术的患者（2023年12月至2025年1月）。非随机分配将患者分为：APSS-DCSD队列（n = 45）和传统DCSD队列（n = 48）。观察指标包括手术时间、出血量、并发症（系带损伤、感染）、术中疼痛（视觉模拟评分法，VAS）、患者满意度和愈合时间。
在出血量（中位数：3.2对3.1 mL；P = 0.66）、愈合时间（中位数：24对23天；P = 0.85）或VAS评分（中位数：3.0对4.0；P = 0.10）方面，未观察到显著的组间差异。APSS-DCSD队列的手术时间更长[7.0对6.5分钟；95%置信区间（CI）：1.708 - 8.809；P < 0.001]，满意度显著更高（中位数评分：5对4；95% CI：3.414 - 20.995；P < 0.001）。总体上有3例发生切口感染（APSS-DCSD：2.2%对DCSD：4.2%；P > 0.99）。两个队列均未记录到严重并发症（血肿、系带损伤）。
APSS-DCSD方法在不影响安全边际的情况下显著提高了解剖精度和患者满意度。其标准化方案在复杂解剖结构中显示出特别的效用，值得进行前瞻性多中心验证。
