Evaluating Safety of Ring Versus Clamp Devices in Neonatal Circumcision: A Meta-Analysis.

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  • Additional Information
    • Source:
      Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE
    • Publication Information:
      Publication: Philadelphia, PA : Saunders
      Original Publication: New York.
    • Subject Terms:
      Circumcision, Male*/instrumentation ; Circumcision, Male*/adverse effects ; Circumcision, Male*/methods; Humans ; Male ; Infant, Newborn ; Randomized Controlled Trials as Topic ; Equipment Design ; Surgical Instruments ; Postoperative Complications/prevention & control ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Operative Time
    • Abstract:
      Background: While device-based circumcision is considered non-inferior to traditional dissection, there is no consensus on the efficacy and safety of ring devices in comparison with clamp devices. We aimed to compare the safety outcomes of ring-based versus clamp-based circumcision techniques in neonates.
      Methods: MEDLINE, EMBASE, Scopus, and CINAHL were searched following the Cochrane collaboration (PRISMA guidelines), without language restrictions, to identify relevant randomized controlled trials. Adverse events, bleeding events, infection events, and procedure time were extracted and analyzed from the selected studies.
      Results: From 1661 citations, seven trials were included, encompassing 3390 patients. These studies compared ring-based to clamp-based circumcision devices in neonates. No significant difference was found in overall adverse events between the two groups. However, ring devices showed significantly fewer bleeding events compared to clamp devices. Infection events and procedure time were similar for both groups.
      Conclusions: Both ring and clamp devices have similar safety profiles, with ring devices potentially offering a reduced risk of bleeding. A comprehensive understanding of ring-specific complications and cosmetic outcomes is necessary for a more complete evaluation of these circumcision techniques. Our analysis is limited from a lack of detailed examination of ring-specific complications and their impact on cosmetic results. The included studies varied in quality, and some exhibited a risk of bias.
      Level of Evidence: Level IV Treatment Study.
      (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: Circumcision; Meta-analysis; Neonates; Systematic review
    • Publication Date:
      Date Created: 20240710 Date Completed: 20240913 Latest Revision: 20240917
    • Publication Date:
      20240917
    • Accession Number:
      10.1016/j.jpedsurg.2024.06.015
    • Accession Number:
      38987062