目的:包茎是儿童泌尿系统的常见病,通常需要手术治疗。然而,儿童包皮环切术的最佳方法尚未确定。我们进行了系统评价和荟萃分析,以比较塑料钳与传统手术包皮环切术在小儿包皮环切术中的安全性和有效性。
方法:进行了文献检索,以比较塑料夹和常规解剖技术在儿科人群中的应用。使用了以下搜索词:“包皮环切术”,\"塑料夹\",\"常规\",\"塑铃\",\"children\"等。Meta分析用于汇集和评估变量,如手术时间,失血,伤口感染,出血,水肿,和术后总并发症。
结果:在9项研究的17,325名参与者中,有10,412人使用了塑料夹钳技术(PCT)。而6913例患者使用了传统的手术解剖技术(CST)。与CST方法相比,PCT方法导致手术时间更短(平均差异(MD)-17.48,95%CI-22至-12.96;P<0.001),失血减少(MD-4.25,95%CI-7.75至-0.77;P=0.02),术后水肿发生率较高(OR2.33,95%CI1.34~4.08;P=0.003)。然而,术后并发症发生率无显著差异,包括PCT和CST之间的伤口感染和出血。
结论:PCT在儿科人群中是一种安全且节省时间的选择。然而,这种方法似乎有明显更高的术后水肿率。
OBJECTIVE: Phimosis is a common condition of the urinary system in children and often requires surgical treatment. However, the optimal method of circumcision for children has not been determined. We conducted a systematic review and meta-analysis to compare the safety and effectiveness of plastic clamp with conventional surgical circumcision in pediatric circumcision.
METHODS: A literature search was carried out to compare the plastic clamp and conventional dissection technique in the pediatric population. The following search terms were used: \"circumcision\", \"plastic clamp\", \"conventional\", \"plastibell\", \"children\" and etc. Meta-analysis was used to pool and evaluate variables such as operative time, blood loss, wound infection, bleeding, edema, and total postoperative complications.
RESULTS: The plastic clamp technique (PCT) was used in 10,412 of the 17,325 participants in the nine studies, while the conventional surgical dissection technique (CST) was used on 6913 patients. When compared to the CST approach, the PCT approach resulted in shorter operative times (mean difference (MD) -17.48, 95% CI -22 to -12.96; P < 0.001), less blood loss (MD -4.25, 95% CI -7.75 to -0.77; P = 0.02), and a higher incidence of postoperative edema (OR 2.33, 95% CI 1.34 to 4.08; P = 0.003). However, no significant difference was found in the incidence of postoperative complications, including wound infection and bleeding between PCT and CST.
CONCLUSIONS: PCT is a safe and time-saving option in the pediatric population. However, this method appeared to have a significant greater rate of postoperative edema.