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Plastic Clamp Versus Conventional Surgical Dissection Technique in Pediatric Circumcision: A Systematic Review and Meta-Analysis

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Abstract

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.

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Data Availability

The dataset used and analyzed during the current study are available from the corresponding author on reasonable request.

References

Papers of particular interest, published recently, have been highlighted as: •  Of importance •• Of major importance

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Funding

This study was supported by the science and technology Project of Suzhou (Grant number SKY2023194 to Qianwei Xiong).

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Authors and Affiliations

Authors

Contributions

Xianming Yao. Conception and design of study, Drafting the manuscript, revising the manuscript. Gang Zhang. Conception and design of study, Drafting the manuscript. Qianwei Xiong. Conception and design of study, acquisition of data, revising the manuscript. Shaoguang Feng. Conception and design of study, analysis and/or interpretation of data. Xian Liu. Conception and design of study, analysis and/or interpretation of data, Drafting the manuscript. All authors read and approved the final manuscript as submitted.

Corresponding author

Correspondence to Xian Liu.

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Yao, X., Zhang, G., Xiong, Q. et al. Plastic Clamp Versus Conventional Surgical Dissection Technique in Pediatric Circumcision: A Systematic Review and Meta-Analysis. Curr Urol Rep (2024). https://doi.org/10.1007/s11934-024-01209-5

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  • DOI: https://doi.org/10.1007/s11934-024-01209-5

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