Outcomes of circumcision in children with single ventricle physiology
Children with single ventricle physiology (SVP) have been shown to have a high morbidity and mortality after non-cardiac surgical procedures. Elective circumcision is one of the most common pediatric operations with low morbidity and mortality. The purpose of our study was to review our institutional experience with SVP children undergoing circumcisions to determine peri-operative course and outcomes.
We performed a retrospective review of children with SVP who underwent an elective circumcision from 2000 to 2017. Children with non-single ventricle physiology or children undergoing circumcision in combination with another case were excluded. Demographics, surgical characteristics, and outcomes were analyzed. Descriptive statistics were performed, all medians were reported with interquartile range.
15 males underwent elective circumcision with a median age at the time of surgery of 1.13 (1.03, 1.38) years. Eighty-four percent underwent their circumcision after their 2nd stage cardiac operation. Most common operative indication was uncomplicated phimosis. Median operative time was 20 (16, 27) mins. Median total length of stay was 229 (185, 242) mins with no admissions. Post-operative complications included two (16%) hematomas with one requiring surgical intervention. There were no deaths.
Children with SVP who undergo elective circumcision may have a higher risk of bleeding.
KeywordsCongenital heart disease Circumcision Hypoplastic left heart syndrome
JS: Data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article, statistics. RS, Jr.: Concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article. AL: Concept and design, data analysis and interpretation, approval of article, statistics. SDSP: Concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article, statistics.
No funding was received to conduct this study.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to disclose.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was waived by our IRB due to the fact that the data collected for this study was retrospective and de-identified.
- 2.Neonatal Circumcision Revisited (1996) Fetus and newborn committee, Canadian Paediatric Society. CMAJ J Assoc Med Can 154(6):769–780Google Scholar
- 8.Knott EM, Fraser JD, Alemayahu H et al (2014) Evaluation of cardiac function during laparoscopic gastrostomy in pediatric patients with hypoplastic left heart syndrome using intraoperative transesophageal echocardiography. J Laparoendosc Adv Surg Tech A 24(10):738–741. https://doi.org/10.1089/lap.2014.0287 CrossRefPubMedGoogle Scholar
- 11.Alemayehu H, Sharp NE, Gonzalez K, Poola AS, Snyder CL, St Peter SD (2017) The role of 2-octyl cyanoacrylate in prevention of penile adhesions after circumcision: a prospective, randomized trial. J Pediatr Surg 52(12):1886–1890. https://doi.org/10.1016/j.jpedsurg.2017.08.052 CrossRefPubMedGoogle Scholar