Modified Circumcision Using the Disposable Circumcision Suture Device in Children: A Randomized Controlled Trial

Rao, Jian-Ming; Huang, Haiyu; Chen, Tao; Yang, Chungang; Pan, Cizhong; Deng, Guangcheng; Shen, Long-Jiang; Qian, Xiaohui; Mei-kang, Peng; Zhou, Huidong; Peng, Hong-Liang

doi:10.1016/j.urology.2020.06.018

Cited by 3 publications

(9 citation statements)

References 25 publications

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“…The median operation time of 31 min in our study was longer than the average of other studies between 6.8–10.2 min [ 15 , 27 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. The longer median operation time in our research may be attributed to our assigned operation time record which included time after the patient entry into the operation room and their leaving, and also the post-operative education time.…”

Section: Discussioncontrasting

confidence: 56%

“…Another comparative study by Huang, C. et al [ 26 ] selected 18 high-quality studies before December 30, 2016, containing 6179 patients, and concluded the same, which could not only be applied to the adults but also to the pediatric group. Further, a seminal study compared the surgical outcomes of 284 patients, aged between 7 and 16 years old [ 27 ], and confirmed the DCSD group as the most efficacious and safest choice, with a relatively lower complication rate and better cosmetic results. In an important study, the Shang Ring, a novel disposable circumcision device that consists of two concentric plastic rings, has been demonstrated to be a safe alternative with short procedure times, and less surgical skill required.…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Taiwanese-Population-Based Clinical Study on Determining the Efficacy and Safety of Disposable Circumcision Anastomat

Chou

Laih

2022

JCM

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Traditional approaches for male circumcision are tedious and could lead to complications such as peri-/postoperative pain, bleeding, and infection. Thus, for the first time, we investigated the surgical outcomes of recently the discovered Disposable Circumcision Anastomat Type A (Dongguan ZSR Biomedical Technology Company Ltd., China), a disposable circumcision suture device (DCSD), in terms of the operation time, surgical complexity, safety, satisfaction, and aesthetic outcomes and most importantly the prognostic factors for postoperative infection. A total of 394 individuals were circumcised, with a mean age, body mass index (BMI), stretched penile length (SPL), and penile circumference of 30.1 ± 7.05 years, 25.47 ± 4.73, 10.12 ± 1.61, and 7 ± 0.73 cm, respectively. Associated comorbidities included diabetes mellitus (6.09%), hypertension (2.03%), gout (1.02%), end-stage renal disease (ESRD, 0.25%), and HIV (0.25%). The mean operation time, average postoperative bleeding, and wound infection rate was 31.4 ± 9.96 min, 2.54%, and 9.39%, respectively. The mean VAS postoperative pain scores at D0 and D1 were 4.4 ± 2.4 and 1.9 ± 1.6, respectively. Moreover, 1.27% of subjects required reoperation, and a 2.03% rate of instrument malfunction was noted. The significant factors associated with the post-operative infection group were age (p = 0.0313), BW (p = 0.0081), BMI (p = 0.0026), penile circumference (p = 0.0343), and DM (p ≤ 0.001). Multivariate analyses revealed only DM as a statistically significant factor (p < 0.001). Our box–whisker plot revealed no significant difference between the HbA1c level of infection (Hb1Ac = 7.77 ± 1.39) and non-infection groups (Hb1Ac = 6.92 ± 1.84). However, a trend of higher glycemic index in the infection group was observed. Conclusively, DSCD could be an effective and safe alternative to performing circumcision. However, in the population with advanced aging, phimosis, elevated BMI, and DM (HbA1C > 9%), users should be highly cautious due to the increased risk of infection, dehiscence, and hematoma.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

A Retrospective Taiwanese-Population-Based Clinical Study on Determining the Efficacy and Safety of Disposable Circumcision Anastomat

Chou

Laih

2022

JCM

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“…Sixteen publications, published between 2011 and 2023, from a total of 2347 connected investigations that met the inclusion criteria were chosen for the investigation. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] The results of these research studies are presented in Table 2. A total of 5838 individuals with circumcision were in the chosen investigations' starting point, 3252 of them were RC, and 2586 were CC.…”

Section: Resultsmentioning

confidence: 99%

“…In investigations that were considered for the metaanalysis, 5838 individuals with circumcision were in the chosen investigations' starting point, 3252 of them were RC, and 2586 were CC. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] RC had significantly lower WIR and WBR compared with those with CC. However, RC and CC had no significant difference in WHR, WER, and WDR.…”

Section: Discussionmentioning

confidence: 99%

Wound healing rates and wound problems of conventional circumcision compared with ring circumcision: A meta‐analysis

Wang

Chen

et al. 2023

International Wound Journal

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A meta‐analysis investigation was executed to measure the wound healing rates (WHRs) and wound problems (WPs) of conventional circumcision (CC) compared with ring circumcision (RC). A comprehensive literature investigation till March 2023 was applied and 2347 interrelated investigations were reviewed. The 16 chosen investigations enclosed 25 838 individuals, with circumcision, were in the chosen investigations' starting point, 3252 of them were RC, and 2586 were CC. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the WHRs and WPs of CC compared with RC by the dichotomous or continuous approaches and a fixed or random model. RC had a significantly lower wound infection rate (WIR) (OR, 0.58; 95% CI, 0.37‐0.91, P = .002) and wound bleeding rate (WBR) (OR, 0.22; 95% CI, 0.12‐0.42, P < .001) compared with those with CC. However, RC and CC had no significant difference in WHR (OR, 2.18; 95% CI, −0.73 to 5.09, P = .14), wound edema rate (WER) (OR, 1.11; 95% CI, 0.92‐1.33, P = .28), and wound dehiscence rate (WDR) (OR, 0.98; 95% CI, 0.60‐1.58, P = .93). RC had significantly lower WIR, and WBR, however, no significant difference in WHR, WER, and WDR compared with those with CC. However, care must be exercised when dealing with its values because of the low sample size of some of the nominated investigations for the meta‐analysis.

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“…The DCSD is a novel device based on bowel anastomotic stapler principles. Some studies have reported its initial application experience, including some comparing study and meta-analysis [7][8][9][10].…”

Section: Discussmentioning

confidence: 99%

The morphological features of the penile raphe and its clinical application in the circumcision using the disposable circumcision suture device

2022

Preprint

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OBJECTIVESto describe the morphological feature of the penile raphe, to solve the frenulum malposition based on the morphological classification of penile raphe in circumcision with the disposable circumcision suture deviceMethodsFrom November 2013 to April 2021, there were 2265 consecutive Chinese patients who underwent circumcision in our hospital. Each patient’s penile raphe morphological feature was recorded and grouped. It could be categorized four type of raphe feature : typeⅠ, the middle raphe; typeⅡ,the middle double raphe or middle band; type Ⅲ, the diamond or lozenge-shaped raphe; type Ⅳ, marked by some hyperpigmentation zone. The case of distinctive type of the penile raphe was treated with different strategy to guarantee the frenum matching. The convexity frenulum cutting site (CFCS) which could be palpated as small rounded eminence tissue at the ventral prepuce during the procedure was also used as an assisting anatomy marker. Other data recorded including operation time, type of anesthesia, intra-operative blood loss, incision healing time, complications and patient satisfactory.RESULTSAccording to the classification system there were 842 (37.2%) cases in type Ⅰ; 258 (11.4%) cases in type Ⅱ; 992 (43.8%) cases in type Ⅲ and 173 (7.6%) cases in type Ⅳ. Following the treatment principle based on the penile raphe feature, no case of notorious frenulum deviation was observed after the 16 cases of frenulum malposition recounted in the first 100 cases in our series. The overall satisfactory rate was high (2185, 93.9%).ConclusionsThe morphological classification of the penile raphe incombinating with the anatomy marker of CFCS will facilitate accurate identification of the frenulum location, better located its right position and cosmetic outcome.

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Modified Circumcision Using the Disposable Circumcision Suture Device in Children: A Randomized Controlled Trial

Cited by 3 publications

References 25 publications

A Retrospective Taiwanese-Population-Based Clinical Study on Determining the Efficacy and Safety of Disposable Circumcision Anastomat

A Retrospective Taiwanese-Population-Based Clinical Study on Determining the Efficacy and Safety of Disposable Circumcision Anastomat

Wound healing rates and wound problems of conventional circumcision compared with ring circumcision: A meta‐analysis

The morphological features of the penile raphe and its clinical application in the circumcision using the disposable circumcision suture device

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