Division of Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Colorectal Surgery Unit, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Updates Surg. 2024 Nov;76(7):2655-2661. doi: 10.1007/s13304-024-02023-x. Epub 2024 Oct 27.
'Fast track' guidelines have incorporated multimodal measures to optimize perioperative outcomes in surgery, with laparoscopy being a pivotal component for its advantages in early recovery. In this setting, current recommendations regarding the use of a urinary catheter suggest its removal within the first 24-hours postoperatively. However, few studies have assessed the feasibility of leaving the operating room without it. The purpose of this study is to compare the perioperative outcomes of patients undergoing elective laparoscopic colonic resections leaving the operating room with and without a urinary catheter.
A retrospective study was conducted utilizing prospectively collected data from patients undergoing elective colon resections over a 17-month period. The patients were classified into two groups based on the presence or absence of a urinary catheter upon leaving the operating room, and subsequently, their perioperative outcomes were compared.
A total of 107 patients met the inclusion criteria (n = 28 with a urinary catheter and n = 79 without). Cancer was the most prevalent diagnosis (83.2%), and right hemicolectomy the most frequently performed surgery (32.7%). Two events of urinary catheter reinsertions were reported, both in the no-catheter group (0% vs 2.53%, p = 0.969), and there were no cases of urinary tract infections. The overall and severe complications rates exhibited no significant differences (25% vs. 26.6%, p = 1, and 7.14% vs. 5.06%, p = 1) and the length of stay was similar (p = 0.220).
Removing the urinary catheter before leaving the operating room appears to be safe and associated with very low rates of urinary retention in selected patients undergoing laparoscopic colonic or upper rectal resections.
“快速通道”指南纳入了多模式措施，以优化手术的围手术期结果，腹腔镜是其早期恢复优势的关键组成部分。在此背景下，目前关于使用导尿管的建议是术后 24 小时内将其移除。然而，很少有研究评估离开手术室时不使用导尿管的可行性。本研究旨在比较接受择期腹腔镜结肠切除术的患者在离开手术室时是否留置导尿管的围手术期结果。
本研究回顾性分析了 17 个月期间接受择期结肠切除术患者的前瞻性收集数据。根据离开手术室时是否留置导尿管，将患者分为两组，随后比较其围手术期结果。
共纳入 107 例符合条件的患者（n=28 例留置导尿管，n=79 例未留置导尿管）。最常见的诊断是癌症（83.2%），最常进行的手术是右半结肠切除术（32.7%）。报告了 2 例导尿管重新插入事件，均发生在无导尿管组（0%比 2.53%，p=0.969），无尿路感染病例。总并发症和严重并发症发生率无显著差异（25%比 26.6%，p=1，7.14%比 5.06%，p=1），且住院时间相似（p=0.220）。
在选定的接受腹腔镜结肠或直肠上段切除术的患者中，离开手术室前拔除导尿管似乎是安全的，且与极低的尿潴留发生率相关。
