CAJ | 학술논문

目的：比较一次性包皮吻合器与传统包皮环切术的临床疗效。方法分析2013年3月至2014年3月采用一次性包皮吻合器与传统包皮环切术治疗的421例包皮过长或包茎患者的临床资料。年龄4岁10个月至57岁，平均23.7岁。其中241例采用一次性包皮吻合器行包皮环切术，180例行传统包皮环切术。结果所有患者均顺利完成手术，吻合器组患者切缘整齐，美观。吻合器组在手术时间、术中出血量及包皮水肿消退时间方面均优于传统的包皮环切术，相比差异有统计学意义（P＜0.05）。而术后并发症两者相比差异无统计学意义（P＞0.05），吻合器组有5例（2.1%）并发症出现，均为术后12h内出现血肿；传统包皮环切组有3例（1.7%）出现并发症，其中2例为包皮血肿，1例为术后7d系带处出现感染化脓糜烂。术后3个月电话随访患者对包皮外观满意度，吻合器组随访到148例，其中1例肥胖患者因术后阴茎头显露不佳感觉不太满意；包皮环切组随访到126例，8例患者对术后外观不满意，其中7例感觉包皮两侧不对称，1例感觉性生活时系带处疼痛不适，经观察无明显缓解，横切纵缝延长系带后症状消失。结论一次性包皮吻合器行包皮环切术临床疗效满意，手术简单，用时短，可做临床推广。
목적：비교일차성포피문합기여전통포피배절술적림상료효。방법분석2013년3월지2014년3월채용일차성포피문합기여전통포피배절술치료적421례포피과장혹포경환자적림상자료。년령4세10개월지57세，평균23.7세。기중241례채용일차성포피문합기행포피배절술，180례행전통포피배절술。결과소유환자균순리완성수술，문합기조환자절연정제，미관。문합기조재수술시간、술중출혈량급포피수종소퇴시간방면균우우전통적포피배절술，상비차이유통계학의의（P＜0.05）。이술후병발증량자상비차이무통계학의의（P＞0.05），문합기조유5례（2.1%）병발증출현，균위술후12h내출현혈종；전통포피배절조유3례（1.7%）출현병발증，기중2례위포피혈종，1례위술후7d계대처출현감염화농미란。술후3개월전화수방환자대포피외관만의도，문합기조수방도148례，기중1례비반환자인술후음경두현로불가감각불태만의；포피배절조수방도126례，8례환자대술후외관불만의，기중7례감각포피량측불대칭，1례감각성생활시계대처동통불괄，경관찰무명현완해，횡절종봉연장계대후증상소실。결론일차성포피문합기행포피배절술림상료효만의，수술간단，용시단，가주림상추엄。
Objective To compare the clinical efficiency of peritomy anastomoses device and traditional circumcision. Methods Clinical data of 421 patients with redundant prepuce or phimosis from March 2013 to March 2014 who underwent peitomy anastomoses device(241 cases) or traditional circumcision(180 cases) were reviewed retrospectively. The mean age of the patients was 23.7 years ( range from 4 years 10 months to 57years). Results All operations were finished successfully for the patients. The cutting-edge of peritomy anastomoses device group was much more concinnous. The peritomy anastomoses device group showed great advantages over the traditional circumcision group in operation time, blood loss and prepuce swelling subsiding (P<0.05). And the postoperative complications had no statistical difference between two methods (P>0.05). Five patients (2.1%) got prepuce haematoma in 12 hours after operation in peritomy anastomoses device group. Three patients (1.7%) in traditional circumcision group got postoperative complications, including two prepuce heamatoma and one prepuce frenulum infection. We followed up the satisfaction of the appearance 3 months after the operation. 148 patients were followed in the peritomy anastomoses device group, and one fat patient was not satisfied because of glans not outrop enough. 126 patients were followed in the traditional circumcision group, and eight patients were not satisfied. Seven of the eight patients felt that the prepuce was not symmetry, and another felt frenulum of prepuce hurt during intercourse, and felt better after fraenotomy. Conclusion Peritomy anastomoses device for circumcision is a convenient and safe technique, which merits to be applied in clinic.