BackgroundThe prepuce (foreskin) is a simple fold of skin formed from an outer keratinized layer and inner mucosallayer, lining a preputial sac and provides functions such as protective, erogenous, and immunologic. Theprepuce is normally non-retractile during neonatal development, as the inner epithelial lining of prepuceand glans adhere each other. Non retractile prepuces are common among young boys and normalpart of preputial development. However, unnecessary circumcision is widely practiced among youngadolescents due to poor understanding of foreskin and lack of medical indication.GoalTo assess preputial retractibility in Mongolian boys at various ages to determine natural process ofpreputial separation.Material and MethodsWe evaluated 1697 Mongolian boys aged 2 to 12. Preputial condition was classifi ed into 5 types basedon preputial retractability: type I-phimosis, type II–partial phimosis, type III–adhesion of prepuce, IV–normal, V–circumcised. We also prospectively evaluated 30 histological materials of patients (2-12 yearsold), who were treated by complete circumcision. The materials were fi xed 10% solution of formalin,embedded in paraffi n, stained with hematoxylin-eosin and examined by 3 pathologists.ResultsThe incidences of type I was 67.9% in 2 years old, 12% in 6years, and 4.1% in 10 years and1.1% in12 years old, respectively. On the contrary, the incidences of type IV were 15.4% in 2 years old, 29.8%in 6 years, 74.7% in 10 years and 91.6% in 12 years. Thecircumcisionswere0% in 2 years old, 5.7%in 6 years old, 2.9% in 10 years old and 5% in 12 years old. Most patients (76.7%) did not have anyhistological alterations of the skin and infl ammatory alteration, not lichen sclerosis, were observed in23.3% in histological examination followed by circumcision.Conclusion: Preputual separation increases with ages in boys and surgical treatment of the phimosisshould be performed with cautions.

Introduction: The introduction of minimally invasive surgery has revolutionized multiple disciplines of surgical practice. Objectives: This meta-analysis of matched case control studies aimed to compare the perioperative outcomes of video-assisted thoracic surgery (VATS) with open thoracotomy for patients with early-stage non-small cell lung cancer (NSCLC). Methods: We searched from PubMed and Embase electronic database and revealed seven relevant studies. Endpoints included perioperative mortality and morbidity, postoperative complications and duration of hospitalization. Two investigators (L.S and D.N) independently reviewed each retrieved article. The values of RR and 95% CI were estimated. We used the fixed and random-effects models to estimate the size of the treatment benefit. Results: Results indicate that perioperative mortality was similar between VATS and open thoracotomy (RR-0.62(95%CI 0.39-0.98). However, patients who underwent VATS were found to have fewer overall complications (RR-0.68(95%CI 0.59-0.78), and patients who underwent VATS had a significantly shorter length of hospitalization compared with those who underwent open thoracotomy (MD= -2.98(95%CI-4.09:-1.87)). Conclusions The present meta-analysis demonstrated superior perioperative outcomes for patients who underwent VATS, including overall complication rates and duration of hospitalization. Therefore, our study suggests that VATS should be performed widely to treat patients with lung cancer in the future.