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Plastic Clamp Versus Conventional Surgical Dissection Technique in Pediatric Circumcision: A Systematic Review and
Xianming Yao1, Gang Zhang2, Qianwei Xiong3
1Department of Pediatric Surgery, Hangzhou Children's Hospital, Hangzhou, Zhejiang, China.
Insights
Plastic clamp technique (PCT) for pediatric circumcision is safe and faster than conventional surgical dissection (CST). While PCT reduces operative time and blood loss, it shows a higher rate of postoperative edema.
Area of Science:
- Pediatric Urology
- Surgical Techniques
- Medical Device Evaluation
Background:
- Phimosis is a common pediatric urinary system condition often requiring surgical intervention.
- The optimal circumcision method for children remains undetermined.
- This study compares plastic clamp technique (PCT) with conventional surgical dissection (CST).
Purpose of the Study:
- To systematically review and meta-analyze the safety and effectiveness of PCT versus CST in pediatric circumcision.
- To compare operative time, blood loss, and postoperative complications between the two techniques.
Main Methods:
- A comprehensive literature search was conducted using terms like "circumcision", "plastic clamp", "conventional", and "children".
- Meta-analysis was employed to pool and evaluate data on operative time, blood loss, wound infection, bleeding, edema, and overall complications.
- Nine studies involving 17,325 participants were analyzed.
Main Results:
- PCT was used in 10,412 participants, and CST in 6913.
- PCT demonstrated significantly shorter operative times (MD -17.48) and less blood loss (MD -4.25) compared to CST.
- PCT was associated with a higher incidence of postoperative edema (OR 2.33), but no significant differences in wound infection or bleeding were found.
Conclusions:
- Plastic clamp technique (PCT) is a safe and time-saving surgical option for pediatric circumcision.
- PCT offers advantages in reduced operative time and blood loss.
- A notable drawback of PCT is its significantly higher rate of postoperative edema.
Purpose:
Phimosis is a common condition of the urinary system in children and often requires surgical treatment. However, the optimal method of circumcision for children has not been determined. We conducted a systematic review and meta-analysis to compare the safety and effectiveness of plastic clamp with conventional surgical circumcision in pediatric circumcision.
Methods:
A literature search was carried out to compare the plastic clamp and conventional dissection technique in the pediatric population. The following search terms were used: "circumcision", "plastic clamp", "conventional", "plastibell", "children" and etc. Meta-analysis was used to pool and evaluate variables such as operative time, blood loss, wound infection, bleeding, edema, and total postoperative complications.
Results:
The plastic clamp technique (PCT) was used in 10,412 of the 17,325 participants in the nine studies, while the conventional surgical dissection technique (CST) was used on 6913 patients. When compared to the CST approach, the PCT approach resulted in shorter operative times (mean difference (MD) -17.48, 95% CI -22 to -12.96; P < 0.001), less blood loss (MD -4.25, 95% CI -7.75 to -0.77; P = 0.02), and a higher incidence of postoperative edema (OR 2.33, 95% CI 1.34 to 4.08; P = 0.003). However, no significant difference was found in the incidence of postoperative complications, including wound infection and bleeding between PCT and CST.
Conclusions:
PCT is a safe and time-saving option in the pediatric population. However, this method appeared to have a significant greater rate of postoperative edema.
