Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Colorectal Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Investig Clin Urol. 2018 Mar;59(2):119-125. doi: 10.4111/icu.2018.59.2.119. Epub 2018 Feb 6.
Placement of pre-operative ureteral catheters for colorectal surgery can aid in the identification of ureteral injuries. This study investigates whether simultaneous ureteral catheterization with surgery skin preparation can minimize operating room times without increasing post-operative complications.
Patients undergoing simultaneous colorectal surgery skin preparation and placement of pre-operative ureteral catheters (n=21) were compared to those who underwent these events sequentially (n=28). Operative time-points of anesthesia ready (AR), surgery procedure start (PS), dorsal lithotomy and catheter insertion (CI) times were compared to assess for differences between groups. Complications were compared between groups.
There were no differences in age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA), comorbidities, current procedure terminology (CPT) or International Classification of Diseases, 9th revision (ICD-9) codes between groups. Simultaneous catheterization saved 11.82 minutes of operative time between CI to PS (p=0.005, t-test). There was a significant difference in mean time between CI to PS (11.82 minutes, p=0.008) between simultaneous and sequential ureteral catheterization groups in a linear regression multivariate analysis controlling for age, BMI, CPT and ICD-9 codes. There were 4 complications in the simultaneous (19%) and 3 in the sequential group (11%) (p=0.68).
Ureteral catheterization and colorectal surgery skin preparation in a simultaneous fashion decreases the time between CI and PS without significant increase in complications. Mean time saved with simultaneous ureteral catheterization was 11.82 minutes per case. Simultaneous ureteral catheterization may be an option in colorectal surgery and may result in cost savings without additional complications.
在结直肠手术中放置术前输尿管导管有助于识别输尿管损伤。本研究旨在探讨在不增加术后并发症的情况下，同时进行手术皮肤准备和术前输尿管置管术是否可以缩短手术时间。
比较了同时进行结直肠手术皮肤准备和术前输尿管导管放置的 21 例患者（同时组）与先后进行这些操作的 28 例患者（序贯组）。比较两组麻醉准备（AR）、手术开始（PS）、俯卧位和导管插入（CI）时间的手术时间点，以评估组间差异。比较两组并发症。
两组间年龄、性别、体重指数（BMI）、美国麻醉医师协会（ASA）评分、合并症、当前操作术语（CPT）或国际疾病分类，第 9 版（ICD-9）代码无差异。同时置管在 CI 到 PS 之间节省了 11.82 分钟的手术时间（p=0.005，t 检验）。在同时和序贯输尿管置管组中，CI 到 PS 之间的平均时间存在显著差异（11.82 分钟，p=0.008），多元线性回归分析控制了年龄、BMI、CPT 和 ICD-9 代码。同时组有 4 例并发症（19%），序贯组有 3 例（11%）（p=0.68）。
同时进行输尿管置管和结直肠手术皮肤准备可缩短 CI 到 PS 之间的时间，且并发症无显著增加。同时行输尿管置管术平均可节省 11.82 分钟/例。在结直肠手术中同时行输尿管置管术可能是一种选择，且可能在不增加并发症的情况下节省成本。
