Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: https://twitter.com/Jameson_Wiener.
Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Am J Surg. 2020 Jun;219(6):983-987. doi: 10.1016/j.amjsurg.2019.09.023. Epub 2019 Sep 24.
Postoperative urinary retention (POUR) and catheter-associated urinary tract infections (CAUTI) are associated with significantly longer hospital length-of-stay and increased costs. This study investigates the effect of early removal of urinary catheters on POUR and CAUTI in patients undergoing an ERP with a preoperative intrathecal injection.
Retrospective cohort study of a prospectively maintained database of patients who underwent elective colorectal surgery in an Enhanced Recovery pathway was compared to historical National Surgical Quality Improvement Program cohort of patients. Primary outcomes measured are 30-day POUR and postoperative CAUTI rates.
The overall POUR rate of ERP patients compared to non-ERP patients was significantly less (8% vs. 13%, p < 0.05). CAUTI rates were not significantly different between pre-ERP and ERP patients (1.2 vs 2.3%, p = 0.19).
For patients undergoing ERP with a preoperative intrathecal opioid injection, early removal of urinary catheter significantly decreased POUR and did not significantly affect CAUTI rates.
The effect of early removal of urinary catheters on postoperative urinary retention and catheter-associated UTI rates in patients undergoing an ERP with a single preoperative intrathecal opioid injection was studied. Early urinary catheter removal after intrathecal injection was associated with decreased rates of POUR and equivalent CAUTI rates.
术后尿潴留（POUR）和与导尿管相关的尿路感染（CAUTI）与住院时间明显延长和成本增加有关。本研究调查了在接受术前鞘内注射的 ERP 患者中早期拔除导尿管对 POUR 和 CAUTI 的影响。
对接受增强恢复途径择期结直肠手术的前瞻性维护数据库中的患者进行回顾性队列研究，并与历史上的国家手术质量改进计划患者队列进行比较。测量的主要结果是 30 天的 POUR 和术后 CAUTI 发生率。
与非 ERP 患者相比，ERP 患者的总体 POUR 率明显较低（8%对 13%，p<0.05）。ERP 患者和非 ERP 患者的 CAUTI 发生率无显著差异（1.2%对 2.3%，p=0.19）。
对于接受术前鞘内阿片类药物注射的 ERP 患者，早期拔除导尿管可显著降低 POUR，且不会显著影响 CAUTI 发生率。
本研究探讨了在单次术前鞘内阿片类药物注射的 ERP 患者中，早期拔除导尿管对术后尿潴留和与导尿管相关的尿路感染率的影响。鞘内注射后早期拔除导尿管可降低 POUR 发生率，CAUTI 发生率相当。
