A Longitudinal Population Analysis of Cumulative Risks of Circumcision.

Autor: Hung YC; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts., Chang DC; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts., Westfal ML; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts., Marks IH; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Northwick Park Hospital, London., Masiakos PT; Harvard Medical School, Boston, Massachusetts; Department of Pediatric Surgery, MassGeneral Hospital for Children, Boston, Massachusetts., Kelleher CM; Harvard Medical School, Boston, Massachusetts; Department of Pediatric Surgery, MassGeneral Hospital for Children, Boston, Massachusetts. Electronic address: ckelleher3@partners.org.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2019 Jan; Vol. 233, pp. 111-117. Date of Electronic Publication: 2018 Aug 18.
DOI: 10.1016/j.jss.2018.07.069
Abstrakt: Background: Circumcision is widely accepted for newborns in the United States. However, circumcision carries a risk of complications, the rates of which are not well described in the contemporary era.
Methods: We performed a longitudinal population analysis of the California Office of Statewide Health Planning and Development database between 2005 and 2010. Using International Classification of Procedures, Ninth Revision, Clinical Modification and Current Procedural Terminology codes, we calculated early and late complication rates by Kaplan-Meier survival estimates. Late complications were defined as those that occurred between 30 d and 5 y after circumcision. Descriptive analysis of complications was obtained by analysis of variance, chi-square test, or log-rank test. On adjusted analysis, a Cox proportional hazard model was performed to determine the risk of early and late complications, adjusting for patient demographics.
Results: A total of 24,432 circumcised children under age 5 y were analyzed. Overall, cumulative complication rates over 5 y were 1.5% in neonates, 0.5% of which were early, and 2.9% in non-neonates, 2.2% of which were early. On adjusted analysis, non-neonates had a higher risk of early complications (OR 18.5). In both neonates and non-neonates, the majority of patients with late complications underwent circumcision revision.
Conclusions: Circumcision has a complication rate higher than previously recognized. Most patients with late complications after circumcision received an operative circumcision revision. Clinicians should weigh the surgical risks against the reported medical benefits of circumcision when counseling parents about circumcision.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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