Does using a laser improve outcomes of conventional circumcision in adult and children populations? Results from a systematic review and meta-analysis.

Autor: Scarcella S; Department of Urology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro-Fano, Italy., Law YXT; Department of Urology, National University Hospital, Singapore, Singapore., Bravi CA; Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.; ORSI Academy, Melle, Belgium., Piazza P; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Heldwein FL; Department of Urology, Federal University of Santa Catarina, Florianopolis, Brazil., Ronchi P; Department of Urology, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Polytechnic University of the Marche Region, Ancona, Italy., Lacetera V; Department of Urology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro-Fano, Italy., Beatrici V; Department of Urology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro-Fano, Italy., Gauhar V; Department of Urology Ng Teng Fong General Hospital (NUHS), Singapore, Singapore., Castellani D; Department of Urology, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Polytechnic University of the Marche Region, Ancona, Italy.; Faculty of Medicine, School of Urology, Polytechnic University of Le Marche, Ancona, Italy.
Jazyk: angličtina
Zdroj: Andrology [Andrology] 2023 Jan; Vol. 11 (1), pp. 54-64. Date of Electronic Publication: 2022 Nov 02.
DOI: 10.1111/andr.13321
Abstrakt: Background: Male circumcision is a well-known old surgery, and several recently developed techniques have been scaled up, including the introduction of laser technology, as alternative approaches to overcome morbidity of conventional surgery scalpel/suture method OBJECTIVES: We aimed to perform a systematic review and meta-analysis of studies comparing laser circumcision versus conventional circumcision technique in terms of perioperative outcomes and efficacy (complications, unacceptable appearance, reoperation rate) both in children and adults.
Materials and Methods: This review was performed following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Continuous variables were analyzed using the inverse variance of the mean difference with a random effect, 95% confidence interval (CI), and p-value. The incidence of complications, unacceptable appearance, and reoperation rate were pooled using the Cochran-Mantel-Haenszel Method with the random effect model and reported as odds ratio (OR), 95% CI, and p-value. Significance was set at p-value ≤0.05 and 95%CI.
Results: Seven studies were included. In comparison to the conventional circumcision, laser circumcision shoved lower visual analogue score at 24-h, and 7 days after surgery, a lower rate of overall complication rate (OR 0.33, 95% CI 0.24-0.47, p < 0.001), scarring (OR 0.09, 95% CI 0.02, 0.41, p = 0.002), and unacceptable appearance (OR 0.09, 95% CI 0.05, 0.15, p < 0.001). We found no statistically significant difference in surgical time, and incidence of bleeding, infection, wound dehiscence, and reoperation rate.
Discussion and Conclusion: Our review infers that laser-assisted circumcision is certainly a safe and strong contender as the procedure of choice in both children and adult populations.
(© 2022 American Society of Andrology and European Academy of Andrology.)
Databáze: MEDLINE
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