一次性商环、吻合器与传统手术治疗包皮过长及包茎的效果比较

Comparison of disposable Shang ring, stapler and traditional operation in the treatment of redundant prepuce and phimosis

目的 比较使用一次性商环、吻合器及传统手术治疗包皮过长及包茎的疗效和并发症发生情况。方法 选取2019年5月至2021年7月云南省滇南中心医院(红河州第一人民医院)泌尿外科收治的960例包皮过长及包茎患者作为研究对象,对其临床资料进行回顾性分析。根据手术方式将其分为一次性包皮商环组(商环组,n=578)、一次性包皮环切吻合器组(吻合器组,n=234)及传统手术方式组(传统手术组,n=148)。比较三组的手术时间、切口水肿率、外观满意度、并发症(包括出血、感染、愈合不良)发生率。结果 三组手术时间比较,差异具有统计学意义(P<0.05);其中吻合器组手术时间短于商环组和传统手术组,商环组短于传统手术组,差异具有统计学意义(P<0.05)。三组切口水肿发生率比较,差异具有统计学意义(P<0.05);其中传统手术组切口水肿发生率低于商环组和吻合器组,吻合器组低于商环组,差异具有统计学意义(P<0.016 7)。三组外观满意度比较,差异具有统计学意义(P<0.05);其中传统手术组外观满意度低于吻合器组和商环组,差异具有统计学意义(P<0.016 7),吻合器组与商环组比较,差异无统计学意义(P>0.016 7)。三组并发症发生率比较,差异具有统计学意义(P<0.05);其中吻合器组并发症发生率高于传统手术组和商环组,商环组高于传统手术组,差异具有统计学意义(P<0.016 7)。结论 一次性商环、吻合器及传统手术治疗包皮过长及包茎各有优缺点,临床上推荐使用商环和吻合器治疗,其更符合医院的实际情况和患者需要,术者可在充分告知患者情况后根据其意愿选择手术方式。

Objective To compare the curative effect and complications of the treatment of redundant prepuce and phimosis with disposable Shang ring, stapler and traditional operation. Methods From May 2019 to July 2021, 960 patients with redundant prepuce and phimosis admitted to the Department of Urology, South Yunnan Central Hospital(Honghe First People′s Hospital) were selected as the study subjects, and their clinical data were analyzed retrospectively. According to the operation mode, they were divided into three groups: Shang ring group(n=578), stapler group(n=234) and traditional operation group(n=148). The operation time, incision edema rate, appearance satisfaction and complications(including bleeding, infection and poor healing) of the three groups were compared. Results There was significant difference in operation time between the three groups(P<0.05);the operation time of the stapler group was shorter than that of the Shang ring group and the traditional operation group, and the Shang ring group was shorter than that of the traditional operation group, the difference was statistically significant(P<0.05). The difference in the incidence of incision edema among the three groups was statistically significant(P<0.05);the incidence of incision edema in the traditional operation group was lower than that in the Shang ring group and the stapler group, and the stapler group was lower than that in the Shang ring group, with a statistically significant difference(P<0.016 7). The difference in appearance satisfaction of the three groups was statistically significant(P<0.05);the appearance satisfaction of the traditional operation group was lower than that of the stapler group and the Shang ring group, and the difference was statistically significant(P<0. 016 7);there was no statistically significant difference between the stapler group and the shang ring group(P>0.016 7). The incidence of complications among the three groups was statistically significant(P<0.05);the incidence of complications in the stapler group was higher than that in the traditional operation group and the Shang ring group, and the Shang ring group was higher than that in the traditional operation group, with a statistically significant difference(P<0.016 7). Conclusions The treatment of redundant prepuce and phimosis with Shang ring, stapler and traditional operation have their own advantages and disadvantages. The use of Shang ring and stapler is recommended in clinical practice, which is more in line with the actual situation of the hospital and the needs of patients. The operator can choose the surgical method according to the patients fully informed.