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Comprehensive safety assessment of diode laser circumcision in children: a retrospective cohort study
Rodrigo Tapia-Borgo1, Lucía L Cuevas-López2, Diana E Villa-Guillén3
1Departamento de Pediatría, Patronato Médico Por una Infancia Plena, Culiacán, Sin.
Insights
Diode laser circumcision in pediatric patients demonstrated a safe procedure with consistent operative times. Further multicenter studies are recommended to confirm these findings in a larger population.
Area of Science:
- Pediatric Surgery
- Laser Technology in Medicine
Background:
- Pediatric circumcision is a common procedure with variable complication rates (0.5-10%).
- Evaluating novel techniques like diode laser circumcision is crucial for improving pediatric surgical outcomes.
Purpose of the Study:
- To assess the safety and efficacy of diode laser circumcision in pediatric patients.
- To analyze operative times and complication rates associated with diode laser circumcision for various pediatric penile conditions.
Main Methods:
- A retrospective cohort study of 51 pediatric patients (≤17 years) undergoing diode laser circumcision.
- Patients presented with phimosis, balanitis, balanitis xerotica obliterans, or paraphimosis.
- Data collected included operative time, acute complications, and reinterventions, with statistical analysis comparing groups and age correlation.
Main Results:
- No significant acute complications such as bleeding or wound dehiscence were reported.
- Median operative time was consistently 15 minutes across all diagnoses and showed no correlation with patient age.
- No reinterventions were necessary, indicating a favorable procedural outcome.
Conclusions:
- Diode laser circumcision in pediatric patients presents a favorable safety profile with predictable operative times.
- The study suggests a promising alternative for pediatric circumcision, though larger, prospective multicenter trials are needed for broader validation.
Background:
Pediatric circumcision is a common procedure, with reported acute complication rates of 0.5-10%. This study evaluated the safety of diode laser circumcision in pediatric patients treated at a private hospital in Culiacán, Sinaloa, Mexico (2022-2023).
Methods:
Retrospective cohort of 51 patients ≤ 17 years who underwent diode laser circumcision diagnosed with phimosis (n = 29), balanitis (n = 13), balanitis xerotica obliterans (n = 5), and paraphimosis (n = 4). General anesthesia was used in patients under 10 years, and local block with sedation in older patients. Acute complications, operative time, and reinterventions were recorded. Operative time was compared by diagnosis using the Kruskal-Wallis test, and age was correlated with procedure duration using Spearman's correlation. Follow-up was performed at postoperative days 7 and 30.
Results:
No significant bleeding, wound dehiscence, or reinterventions were observed. Median operative time was 15 minutes across all groups, with similar means among diagnoses. No correlation was found between age and procedure duration (r: -0.08; p = 0.593) and no significant differences were observed among diagnoses (p = 0.183).
Conclusions:
Diode laser pediatric circumcision showed a favorable safety profile and homogeneous operative times. The limited sample size restricts generalizability, requiring prospective multicenter studies to confirm these findings.
