商环包皮环切术两种术式比较的Meta分析

No-flip method versus external method for Shang Ring circumcision: A meta-analysis

目的:应用Meta分析评价内置法与外置法商环包皮环切术的临床疗效与安全性。方法:检索国内外有关比较商环内置法与外置法包皮环切术的随机对照试验,由2名评论者分别按Cochrane系统评价方法对纳入文献进行质量评价和提取资料数据后,采用Rev Man 5.1.0统计软件进行Meta分析。结果:共纳入7篇文献,1 200例患者。Meta分析结果显示,与外置式相比,商环内置术式具有总并发症率低(RR=0.40,95%CI:0.18,0.87,P=0.02),术后伤口水肿率低(RR=0.28,95%CI:0.09,0.81,P=0.02),同时可以减轻患者术后24 h疼痛(MD=-0.35,95%CI:-0.55,-0.14,P<0.001)的优点。结论:商环内置式包皮环切术相比外置式,具有减少术后总并发症率和术后伤口水肿率、降低术后24 h疼痛度等优点。由于纳入文献较少,需要更多大样本量的随机对照试验进一步证实我们的结论。

Objective ： To compare the effect and safety of the no-flip method versus the external method in Shang Ring circumcision. Methods ： We searched relevant randomized controlled trials published in China and abroad comparing the no-flip method and external method of Shang Ring circumcision. Based on the Cochrane Handbook for systematic review, two reviewers independently evaluated the quality of the included studies and abstracted relevant data, followed by a meta-analysis using the statistical software Review Manager 5.1.0. Results ： Totally 7 studies with 1 200 cases were included. Compared with the external method, the no-flip method was associated with a lower total rate of complications （ RR = 0.40, 95 % CI： 0.18, 0.87, P = 0.02）, a lower incidence of postoperative edema （ RR = 0.28, 95% CI ： O. 09, O. 81, P = 0.02）, and a lower 24 h postoperative pain score （ MD = - 0. 35, 95% CI： - 0.55, - 0.14, P 〈 0.001 ）. Conclusion ： The no-flip method of Shang Ring circumcision was superior to the external method for its advantages of fewer complications, lower incidence of postoperative edema, and mild postoperative pain. However, our findings need further support by more high-quality randomized controlled trials.