目的 比较改良包皮环切缝合器法(缝合器组)与传统包皮环切法(传统手术组)治疗包皮过长及包茎的临床疗效。方法 分析本专科近2年收治的300例手术患者(缝合器组209例,传统手术组91例)。对比手术时间、术中出血量、术后疼痛、术后排尿情况、愈合后外观满意度。采用视觉模拟评分(VAS)评估术后疼痛。结果 缝合器组手术时间为(5.41±1.39)min,术中出血量(2.41±1.66)mL,术后疼痛评分(3.59±0.89)分, 切口愈合时间(7.36±1.33)d。传统手术组手术时间为(33.96±2.62)min。术中出血量(15.40±3.66)mL,术后疼痛评分(4.76±1.17)分, 切口愈合时间(8.15±2.13)d。缝合器组在手术时间、出血量、术后疼痛评分、切口愈合时间、愈合后外观方面均优于传统手术组(P<0.05),且疼痛主要在术后6 h内。而术后出血、血肿发生率两组相近。上述并发症分别经血肿清除、切口再缝合、加压包扎及口服抗炎消肿药物等处理后愈合。术后1月内缝合钉未脱落18例(8.61%),返院人工去除。两组均未出现切口裂开,包皮口狭窄。结论 一次性包皮环切缝合器行包皮环切术具有创伤小、痛苦小、并发症少、安全性高、外观整齐美观等优点,但也要掌握手术关键环节的技巧以减少并发症的发生。

Objective To compare the clinical efficacy of modified disposable circumcision stapler and conventional circumcision in the treatment of redundant prepuce. Methods 300 patients with redundant prepuce or phimosis from May 2014 to May 2016 with who underwent modified disposable circumcision stapler (n=209) or traditional circumcision (n=91) were reviewed retrospectively. Comparisons were made between the two groups in the operation time, blood loss, postoperative pain score, time of wound healing, post-circumcision bleeding and postoperative satisfaction with penile appearance. Results The disposable circumcision stapler group showed great advantages over the traditional circumcision group in mean operation time, blood loss, postoperative visual analog scale (VAS) score for pain, time to wound healing and postoperative satisfaction with the penile appearance (P<0.05). However, there were no significant difference in post-circumcision bleeding, and other complications (P>0.05). Conclusion The disposable circumcision stapler is of convenience, safety and efficacy with shorter operation time, less pain and less complication. However, we should improve operative skills and avoid postoperative complications.