Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
Langenbecks Arch Surg. 2022 Nov;407(7):2929-2935. doi: 10.1007/s00423-022-02582-w. Epub 2022 Jun 24.
A recent trend in urinary catheter management in patients who underwent laparoscopic rectal cancer surgery is early removal. However, some patients develop bladder dysfunction and require urinary re-catheterization. In 2016, a scoring system to predict bladder dysfunction after laparoscopic rectal cancer surgery was developed in our institution. The aim of this study was to demonstrate the validity of this scoring system and to determine the suitability of patients for early removal of urinary catheter.
A single-center, retrospective study from a prospective database was conducted on 234 patients who underwent elective laparoscopic rectal cancer surgery between January 2016 and December 2019. According to bladder dysfunction predictive score, the urinary catheter was removed on the first postoperative day (low-risk group) and fifth postoperative day (high-risk group). After catheter removal, all patients were managed using in-house protocols.
Of 234 patients, 130 (55.6%) were classified as a low-risk group. The overall incidence of bladder dysfunction was 8.5% (11/130) in the low-risk group and 13.5% (14/104) in the high-risk group.
The scoring system developed to predict bladder dysfunction showed good overall performance for discriminating between patients suitable or not for early removal of urinary catheter after laparoscopic rectal cancer surgery.
在接受腹腔镜直肠癌手术的患者中，最近出现了一种导尿管管理的新趋势，即尽早拔除导尿管。然而，一些患者会出现膀胱功能障碍，需要重新导尿。2016 年，我们机构开发了一种预测腹腔镜直肠癌手术后膀胱功能障碍的评分系统。本研究旨在验证该评分系统的有效性，并确定患者是否适合早期拔除导尿管。
对 2016 年 1 月至 2019 年 12 月期间接受择期腹腔镜直肠癌手术的 234 例患者进行了一项来自前瞻性数据库的单中心回顾性研究。根据膀胱功能障碍预测评分，导尿管在术后第 1 天（低危组）和第 5 天（高危组）被拔除。导尿管拔除后，所有患者均采用内部方案进行管理。
在 234 例患者中，130 例（55.6%）被归类为低危组。低危组膀胱功能障碍总发生率为 8.5%（11/130），高危组为 13.5%（14/104）。
该评分系统可预测膀胱功能障碍，对区分腹腔镜直肠癌手术后适合或不适合早期拔除导尿管的患者具有良好的总体性能。
