单人操作包皮环切器实施精准定位包皮环切术的临床研究

A Clinical Study of Precise Positioning Circumcision Performed by Single-person Using Disposable Circumcision Suture

目的探讨单人操作一次性包皮环切缝合器实施包皮环切术,术中进行精准定位切割的技术要点及术后管理方法。方法回顾性分析完全单人操作一次性包皮环切缝合器实施的包皮环切术患者70例,其中包茎12例,包皮过长58例,术中应用标记切割线法对包皮切割部位进行精准定位,观察并记录手术时间及切口疼痛评分;术后充分告知患者注意事项,观察患者切口出血、感染及愈合情况,进行全程管理。结果本组70例患者,手术过程均顺利,手术时间5. 6～9. 8min,术后出血2例,术后疼痛明显3例。常规于术后第1天及第4天时进行切口换药,切口少量渗血16例,19例患者在术后第7天拆除纱布后出现轻度水肿;术后出现系带对合不良1例,钉夹嵌顿1例;未发生系带损伤、阴茎头坏死、系带过短等并发症。结论单人操作一次性包皮环切缝合器进行包皮环切术是一种安全、微创、简便、可行的治疗方式,术中进行精准定位切割及术后进行密切随访管理是手术成功的关键。

Objective To investigate the technical points and postoperative management of precise positioning circumcision performed by single-person disposable circumcision suture. Methods Retrospective analysis of 70 patients with circumcision performed by a single-person disposable circumcision suture,including 12 cases of phimosis and 58 cases of redundant prepuce. During operation,the cutting line method was used to accurately position the foreskin cutting site. The operation time and the pain score of the incision were observed and recorded during the operation. The patients were fully informed of the precautions after the operation,and the bleeding,infection and healing of the incision were observed,and the whole process was managed. Results There were 70 patients in this group,and the operation process was smooth with 5. 6 to 9. 8 minutes of the operation time. Among these 70 patients with precise positioning circumcision,2 cases suffered from postoperative bleeding,and 3 cases suffered from postoperative pain. Incision dressing was routinely performed 1 day and 4 days after surgery,with 16 cases of small infiltration of incision and 19 cases of edema after removal of gauze on the 7 th day after surgery. There were 2 cases suffered from complications after operation including 1 case of poor ligature and 1 case of nail clip incarcerated. No ligament injury,necrosis of the glans,and too short ligament took place. Conclusions Circumcision performed by single-person circumcision suture is a safe,minimally invasive,simple and feasible treatment. Accurate positioning and cutting during operation and close follow-up management are important steps for success.