title: [No-flip method versus external method for Shang Ring circumcision: a meta-analysis].
abstract: OBJECTIVE
  To compare the effect and safety of the no-flip method versus the external method in Shang Ring circumcision.
  
  
  METHODS
  We searched relevant randomized controlled trials published in China and abroad comparing the no-flip method and external method of Shang Ring circumcision. Based on the Cochrane Handbook for systematic review, two reviewers independently eval- uated the quality of the included studies and abstracted relevant data, followed by a meta-analysis using the statistical software Review Manager 5.1.0.
  
  
  RESULTS
  Totally 7 studies with 1 200 cases were included. Compared with the external method, the no-flip method was associated with a lower total rate of complications (RR = 0.40, 95% CI: 0.18, 0.87, P = 0.02), a lower incidence of postop- erative edema (RR = 0.28, 95% CI: 0.09, 0.81, P = 0.02), and a lower 24 h postoperative pain score (MD = -0.35, 95% CI: -0.55, -0.14, P < 0.001).
  
  
  CONCLUSIONS
  The no-flip method of Shang Ring circumcision was superior to the external method for its advantages of fewer complications, lower incidence of postoperative edema, and mild postoperative pain. However, our findings need further support by more high-quality randomized controlled trials.
authors.affiliation: Department of Urology, Sichuan University, Chengdu, China.
authors.forename: De-Hong
authors.initials: DH
authors.lastname: Cao
authors.forename: Liang-Ren
authors.initials: LR
authors.lastname: Liu
authors.forename: Lu
authors.initials: L
authors.lastname: Yang
authors.forename: Sheng-Qiang
authors.initials: SQ
authors.lastname: Qian
authors.forename: Jun-Hao
authors.initials: JH
authors.lastname: Lei
authors.forename: Jiu-Hong
authors.initials: JH
authors.lastname: Yuan
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
mesh_terms: D002681:China; D002944:Circumcision, Male / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D004487:Edema / Q000453:epidemiology; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic