Combined use of CO2 laser and tissue glue versus conventional surgical techniques for circumcision – A prospective study

Mungnirandr, Akkrapol; Wiriyakamolphan, Suwanna; Ruangtrakool, Ravit; Ngerncham, Monawat; Tumrongsombutsakul, Sureerat; Leumcharoen, Bungorn

doi:10.1515/plm-2015-0013

Cited by 5 publications

(9 citation statements)

References 14 publications

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“…Xu et al stated that there were shorter operative times, less blood loss, and a lower postoperative complication rate in the laser group compared to the conventional group [3]. Mungnirandr et al reported similar conclusions as well [10]. They found that the CO 2 laser and tissue glue method were a good procedure with a significantly shorter operative time, lower proportion of tissue with local irritation, and good cosmetic appearance.…”

Section: Discussionmentioning

confidence: 87%

Use of Holmium YAG laser in circumcision: a novel, less complicated and alternative procedure for adolescent

et al. 2020

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Background To evaluate the efficacy and safety of Holmium YAG laser circumcision in adolescents. Methods Eighty-one patients underwent circumcision for medical reasons, and patients’ requests were collected retrospectively during February 2017 to February 2019. They were divided into two groups: Holmium YAG laser (group 1, n = 41) and conventional group (group 2, n = 40). The guillotine method with a Holmium YAG laser was applied for circumcisions, and all the procedures were performed by a single urologist who was well-experienced with circumcision practices. Results The average age of group 1 was 15.53 ± 7.35 years old, and the average age was 16.34 ± 9.22 years old in group 2. There was no significant difference in age and indications. The average operative time was significantly shorter in group 1 than in group 2 (24.40 ± 3.94 vs. 27.25 ± 4.35 min, p < 0.01). The estimated blood loss was less in group 1 compared to group 2. There were fewer complications in group 1 than in group 2 (3/41 vs. 10/40, p < 0.01) and patients also felt less pain in group 1 (p < 0.01). All patients tolerated this procedure without severe side effects. Conclusions The use of Holmium YAG laser in circumcision is a novel, less complicated, easy, and less painful alternative procedure for circumcision in young males.

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Section: Discussionmentioning

confidence: 87%

Use of Holmium YAG laser in circumcision: a novel, less complicated and alternative procedure for adolescent

et al. 2020

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“…We did not evaluate postoperative pain in this study. Furthermore, a very recently report shown that pain score is not significant different between laser and conventional technique ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…There are some reports on sutureless circumcision using cyanoacrylate ( 17 , 18 ). However, very recently only one report has used the combination of a CO 2 laser and cyanoacrylate for circumcisions in a small series (30 patients) ( 19 ). Therefore, this study examined the combined use of a CO 2 laser and cyanoacrylate for shortening the operating time and reducing complications related to bleeding, in comparison with the conventional guillotine method in a bigger series with 150 patients.…”

Section: Introductionmentioning

confidence: 99%

A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

et al. 2016

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Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications.Materials and Methods : Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6–9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic.Results No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33%) occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6–9) minutes. The conventional guillotine group comprised one hematoma (1.3%), two wound dehiscences (2.6%), and two hemorrhages (2.6%), and the median operating time was 22 (range 20–26) minutes. The difference in surgical time was significant (p<0.001), with no significant difference in the rate of complications between the two groups.Conclusion The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone.

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“…Finally, seven studies were considered eligible and included in the analysis. 6,[11][12][13][14]17,18 Figure 1 summarizes the 2020 PRISMA flow diagram. Among included studies, only one was prospective and randomized, 6 five were retrospective, 11,12,14,17,18 and the remaining one was prospective and nonrandomized.…”

Section: Literature Screeningmentioning

confidence: 99%

“…11,12 In fact, Mungnirandr et al capitalized on its hemostatic and wound healing properties and were able to use it with tissue glue with excellent outcomes. 13 Holmium YAG laser is characterized by a wavelength of 2140 nm with penetration into tissues of 0.4 mm allowing coagulation, vaporization, and soft tissue incision. The most frequently used pulse duration is 250-350 µs with a pulse energy of 4.0 J per pulse and a frequency of 5-8 Hz with an average power of 80 watts.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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Combined use of CO2 laser and tissue glue versus conventional surgical techniques for circumcision – A prospective study

Cited by 5 publications

References 14 publications

Use of Holmium YAG laser in circumcision: a novel, less complicated and alternative procedure for adolescent

Use of Holmium YAG laser in circumcision: a novel, less complicated and alternative procedure for adolescent

A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

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

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