包皮环扎术与传统包皮环切术临床疗效的比较分析

目的比较分析包皮环扎术与传统包皮环切术的临床疗效。方法收集2007年9月-2008年11月间来本院门诊就诊的包皮过长患者148例,其中行传统包皮环切术77例,行包皮环扎术71例,比较两组患者的手术操作、术后并发症及治疗效果。结果传统包皮环切术需在神经根阻滞麻醉下由2位术者配合完成,而包皮环扎术不需麻醉,且由1位术者就可顺利完成。环扎组手术时间显著短于传统环切组（P〈0．001）,术后外观满意度显著高于传统环切组（P〈0．001）,平均包皮水肿时间显著短于传统环切组（P〈0．001）;但是环扎组的术后切口感染率显著高于传统环切组（P=0．001）,伤口愈合时间显著长于传统环切组（P〈0．001）。结论包皮环扎术操作简单,技术稳定,疗效确切,值得在临床推广使用。     

Circumcision : A Time to Rethink

Background

Circumcision is one of the most routinely done surgery world over but has no scientific basis to enforce it on all patients. Of late, the operation has been criticized, non-operative methods have been tried and operations preserving the skin of prepuce have been recommended. The presence of physiological phimosis, which is self-correcting by the age of 15 years in children, needs to be differentiated from the pathological variety.

Method

The child population reporting to Surgery OPD was taken as sectional representative of the Indian communities and socioeconomic strata. A simple protocol was adapted to differentiate true phimosis from the physiological one and data collected. An observational study was done and data collected for last six years.

Result

566 children were referred to the hospital and only 212 were subjected to circumcision. Of these, 169 were cases of true phimosis, 7 had paraphimosis and the rest included 9 ritual circumcisions.

Conclusion

The incidence in this study is much less as compared to the series from the west. Though rare, this simple surgery is often fraught with complications. A refined approach has been planned for referring cases and selection for surgery thereby reducing unnecessary referrals and circumcisions.Key Words: Circumcision, Phimosis     

X chemotherapy, myth and realities

Cancer chemotherapy is slowly moving into the world of reality from the realms of myth. Surgery, radiation, chemotherapy, biologic therapy and a combination of these are some of the present modalities in treating cancer. The authors have briefly described in this article the chemotherapeutic aspects of therapy.     

圣环包皮术与包皮环切术的临床疗效对比

目的比较圣环包皮术与包皮环切术的临床疗效。方法对287例包茎、包皮过长患者行包皮环切术(A组),对301例行圣环包皮术(B组),对比分析上述两组患者手术时间、术中及术后出血量、术后并发症等情况。结果两种术式的手术时间、术中及术后出血量间差异均有统计学意义(P<0.05)。两组患者换药率、术后感染率、拆线率以及术后并发症率间差异亦均有统计学意义(P<0.05)。结论圣环包皮术明显优于包皮环切术组,具有微创的特点,值得在临床推广。