Comparison of Early Complications of Modified Dorsal Slit and Excision with Thermocautery Assisted Circumcision Techniques According to the Clavien-Dindo Classification System
Abstract
Background: Circumcision is one of the most frequently performed surgical procedures worldwide. While generally considered safe, the complication profiles of different circumcision techniques remain a subject of debate. This study aimed to compare early postoperative complications of two common techniques—modified dorsal slit and excision ver-sus thermocautery-assisted circumcision—using the standardized Clavien-Dindo classification system.
Methods: A retrospective review was conducted on 964 circumcisions performed between January 2019 and June 2022 in males aged 7–17 years. Patients were allocated into two groups: Group 1 underwent the modified dorsal slit and exci-sion technique (n=558), while Group 2 underwent thermocautery-assisted circumcision (n=406). The primary outcome was early postoperative complications classified by the Clavien–Dindo system. Secondary outcomes included operative time and length of hospital stay.
Results: The overall complication rate was 9.4%, with edema being the most common (8.0%). Group 1 had a significant-ly higher complication rate (12%) than Group 2 (5.9%) (p=0.012). Grade 1 complications occurred more frequently in Group 1 (10.9%) than Group 2 (5.7%) (p=0.004). Higher-grade complications (Grade 2 and 3a) were rare and not statis-tically different between groups. No Grade 3b or more severe complications were observed. Mean operative time and length of hospital stay were significantly shorterin Group 2 (5 minutes and 0–1 day) compared to Group 1 (9 minutes and 1–4 days) (p<0.001).
Conclusions: Thermocautery-assisted circumcision demonstrated fewer early complications and shorter operative time and hospital stay compared with the modified dorsal slit and excision technique. These findings support thermocautery as a safe and efficient option in clinical practice.
Keywords
Circumcision, thermocautery, dorsal slit, complication, Clavien-Dindo classification
Supporting Institution
None.
Ethical Statement
The study was conducted retrospectively with approval from the Ağrı İbrahim Çeçen University Scientific Research Ethics Committee (Deci-sion No: 129, Date: 25.05.2022).
Thanks
None.
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