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Use of a disposable circumcision suture device versus conventional circumcision: a systematic review and meta-analysis

机译:与传统的包皮环切术相比一次性包皮环切缝合器的使用:系统评价和荟萃分析

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摘要

This systematic review assessed the safety and efficacy of the disposable circumcision suture device (DCSD) and conventional circumcision (CC) in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials (RCTs) using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs (1898 cases) were included. Compared with the CC group, the DCSD group had a shorter operative time (standardized mean difference [SMD] = −21.44; 95% confidence intervals [95% CIs] [−25.08, −17.79]; P < 0.00001), shorter wound healing time (SMD = −3.66; 95% CI [−5.46, −1.85]; P < 0.0001), less intraoperative blood loss (SMD = −9.64; 95% CI [−11.37, −7.90]; P < 0.00001), better cosmetic penile appearance (odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P < 0.00001), lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.
机译:该系统评价评估了一次性包皮环切缝合设备(DCSD)和常规包皮环切术(CC)在治疗多余包皮过长和包茎中的安全性和有效性。两名独立评论者使用DCSD和CC进行了文献检索,以寻找在中国和国外治疗多余包皮过长或包茎的随机对照试验(RCT)。纳入9篇RCT(1898例)。与CC组相比,DCSD组的手术时间更短(标准化平均差[SMD] = −21.44; 95%的置信区间[95%CI] [−25.08,−17.79]; P <0.00001),伤口愈合时间更短时间(SMD = −3.66; 95%CI [−5.46,-1.85]; P <0.0001),术中失血更少(SMD = −9.64; 95%CI [−11.37,−7.90]; P <0.00001),更好美观的阴茎外观(优势比[OR] = 8.77; 95%CI [5.90,13.02]; P <0.00001),术中疼痛评分更低,术后24小时疼痛评分更低,感染发生率更低,切口水肿更少,更少不良事件。 CC和DCSD组之间的裂开或血肿发生率没有差异。荟萃分析的结果表明,DCSD比CC更安全,更有效。但是,还需要具有更多研究人群的其他高质量RCT。

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