Division of General Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Division of General Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
J Surg Res. 2019 Nov;243:83-89. doi: 10.1016/j.jss.2019.05.005. Epub 2019 Jun 3.
Postoperative urinary retention (POUR) can impact quality outcomes, leading to urinary tract infections, longer lengths of stay, and increased healthcare costs. The incidence of POUR in bariatric patients is unknown. Our primary objective was to determine the incidence and risk factors contributing to POUR in primary bariatric surgery.
A retrospective review was conducted on patients who underwent a laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) from 2013 to 2017. POUR was defined as the inability to urinate postoperatively, requiring urinary catheterization. Univariate and multivariate analyses were performed on perioperative variables and their correlation with POUR.
During the study period, 603 patients underwent surgery: 317 (52.6%) LSG and 286 (47.4%) LRYGB. Overall, 49 (8.1%) patients developed POUR. There were no significant differences in preoperative demographics between patients with and without POUR. Patients who underwent an LSG had an increased incidence of POUR compared with LRYGB (P = 0.002). In both procedures, POUR was associated with decreased neostigmine, isolated nondepolarizing muscle relaxant, and reduced intraoperative fluid. LSG and congestive heart failure, as well as LSG and body weight, were independently associated with POUR. Female patients who experienced POUR had significantly increased length of stay.
Risk factors associated with POUR after primary bariatric surgery include LSG, less intraoperative neostigmine and intravenous fluids, and isolated nondepolarizing muscle relaxants. These risk factors can help educate patients and providers, as well as identify quality initiatives that focus on perioperative and anesthetic management to reduce POUR and length of hospital stay.
术后尿潴留（POUR）会影响生活质量，导致尿路感染、住院时间延长和医疗费用增加。减重患者发生 POUR 的情况尚不清楚。我们的主要目的是确定原发性减重手术中 POUR 的发生率和促成因素。
对 2013 年至 2017 年间接受腹腔镜袖状胃切除术（LSG）或腹腔镜 Roux-en-Y 胃旁路术（LRYGB）的患者进行了回顾性研究。POUR 被定义为术后无法排尿，需要导尿。对围手术期变量及其与 POUR 的相关性进行了单因素和多因素分析。
研究期间，共有 603 例患者接受了手术：317 例（52.6%）LSG 和 286 例（47.4%）LRYGB。总体而言，有 49 例（8.1%）患者发生了 POUR。有 POUR 患者与无 POUR 患者术前人口统计学特征无显著差异。与 LRYGB 相比，LSG 患者 POUR 发生率增加（P=0.002）。在两种手术中，POUR 与新斯的明减少、非去极化肌松剂单独使用和术中液体减少相关。LSG 和充血性心力衰竭，以及 LSG 和体重，与 POUR 独立相关。发生 POUR 的女性患者的住院时间明显延长。
原发性减重手术后发生 POUR 的相关风险因素包括 LSG、术中新斯的明和静脉液体减少、非去极化肌松剂单独使用。这些风险因素可以帮助教育患者和医护人员，并确定注重围手术期和麻醉管理的质量改进措施，以减少 POUR 和住院时间。
