Abstract:

Objective　To investigate strategies for preventing and managing postoperative complications related to disposable circumcision suture, and to improve the implementation of this technique in pediatric surgery. Methods　Clinical data of 1 932 children with phimosis aged 5-8 year admitted to Hexian Memorial Hospital, Panyu District from February 2018 to August 2023 were retrospectively analyzed, with an age of (6.41±0.14) years old. All children underwent sevoflurane inhalation anesthesia and were treated with disposable circumcision suture under the hospital's "completely painless concept". The complications related to the surgery were recorded and analyzed. Results　All the children successfully completed the procedures, and the total operation time was 4.5-6.5 min, with an average of 5.2 min. The postoperative follow-up lasted from 2 to 8 months, with an average of 6.5 months. In 121 (6.26%) children, frenulum active bleeding occurred during operation. The overall incidence of postoperative complications was 5.64% (109/1 932). Among them, the incidence of short-term complications (<7 days) was 3.26% (63/1 932), including 32 cases of delayed hematoma, 8 cases of dysuria, 4 cases of device failure, 15 cases of wound infection, and 1 case of accidental external urethral injury. The incidence of mid-term complications (7-30 days) was 1.55% (30/1 932), including 10 cases of foreskin edema and 20 cases of difficulty with nail removal. The incidence of long-term complications (>30 days) was 0.98% (19/1 932), including 9 cases of secondary scar-related phimosis and 10 cases of skin bridge formation. Despite these complications, all children recovered and returned to normal health. Conclusions　To further reduce postoperative complications, surgical processes should be standardized, technical skills refined, and education for both children and parents strengthened. Additionally, improvements to disposable circumcision suture devices are recommended. The application of disposable circumcision suture devices within the "completely painless concept" enhances satisfaction among children and parents, making it a valuable approach for broader clinical implementation.

Key words:

Circumcision, Phimosis, Disposable circumcision suture, Complications, Children

摘要：

目的　探讨应用包皮切割缝合器治疗儿童包茎手术相关并发症的防治策略，为更好地开展这一临床技术保驾护航。方法　回顾性分析2018年2月至2023年8月就诊于广州市番禺区何贤纪念医院的1 932例5～8岁包茎儿童临床资料，年龄（6.41±0.14）岁。所有患儿均采用七氟烷吸入麻醉，在全程完全无痛状态下应用一次性包皮切割缝合器进行包皮环切手术。统计术中、术后相关并发症发生情况。结果　所有患儿均顺利完成手术。手术完成时间为4.5～6.5 min，平均5.2 min。术后随访2～8个月，平均6.5个月。121例（6.26%）儿童术中发生系带活动性出血，109例（5.64%）儿童术后发生相关并发症。其中术后近期并发症（<7 d）发生率为3.11%（60/1 932），分别为迟发血肿32例、排尿困难8例、器械故障4例、创面感染15例、误伤尿道外口1例；中期并发症（7～30 d）发生率为1.55%（30/1 932），分别为包皮水肿10例、脱钉困难20例；远期并发症（>30 d）发生率为0.98%（19/1 932），分别为继发瘢痕束缚性包茎9例、皮桥形成10例。所有患儿并发症均得到妥善处理。结论　在全程完全无痛理念下应用包皮环切缝合器治疗儿童包茎，须规范手术操作流程，熟练掌握操作技巧以及加强术后护理宣教，有助于降低儿童包茎手术相关并发症。

关键词:

包皮环切术, 包茎, 一次性包皮切割缝合器, 并发症, 儿童