Banks Kian C, Sun Angela, Le Sidney T, Wei Julia, Hsu Diana S, Ely Sora, Barnes Katherine E, Wile Rachel K, Maxim Clara, Ashiku Simon K, Patel Ashish R, Velotta Jeffrey B
Department of Thoracic Surgery, Kaiser Permanente Northern California, 3600 Broadway, Oakland, CA 94611 USA.
Department of Surgery, UCSF East Bay, 1411 E 31st St, Oakland, CA 94602 USA.
Surg Pract Sci. 2022 Dec 17;12:100150. doi: 10.1016/j.sipas.2022.100150. eCollection 2023 Mar.
Faster time to ambulation (TTA) after video assisted thoracoscopic surgery (VATS) is associated with improved outcomes. We hypothesized that reduced urinary catheter duration leads to shorter TTA after VATS lobectomy.
We studied VATS lobectomy patients from 2014 through 2018. TTA of patients that did not have urinary catheters or whose catheters were removed at the end of the operation (reduced cath) was compared to TTA of those whose catheters were removed the day after surgery (long cath).
Overall, 67 and 234 patients were included in the reduced cath and long cath groups, respectively. Median TTA was shorter in the reduced cath group compared to the long cath group (6.5 h Q1-Q3: 4.8-10.7 vs 11.0 h Q1-Q3: 6.8-18.3, <0.01). Length of stay, urinary complications, and 30-day readmissions were not significantly different between groups.
While it is possible to ambulate with a urinary catheter in place, the presence of such a catheter nevertheless presents an additional barrier to early mobilization among VATS lobectomy patients. Despite other efforts to promote early ambulation within our integrated health system, we have found that avoiding urinary catheter use or removing them immediately post-operatively is associated with shorter times to initial ambulation. Given the known benefits of early ambulation among VATS lobectomy patients, reduction or omission of urinary catheters may provide an additional tool for surgeons to promote early mobilization.
Reduction of urinary catheter duration is associated with reduced TTA after VATS lobectomy.
电视辅助胸腔镜手术(VATS)后更快的下床活动时间(TTA)与改善的预后相关。我们假设减少导尿管留置时间可导致VATS肺叶切除术后TTA缩短。
我们研究了2014年至2018年期间接受VATS肺叶切除术的患者。将未留置导尿管或在手术结束时拔除导尿管(减少导尿管留置)的患者的TTA与术后第一天拔除导尿管(长导尿管留置)的患者的TTA进行比较。
总体而言,减少导尿管留置组和长导尿管留置组分别纳入了67例和234例患者。减少导尿管留置组的中位TTA比长导尿管留置组短(6.5小时,第一四分位数-第三四分位数:4.8-10.7 vs 11.0小时,第一四分位数-第三四分位数:6.8-18.3,<0.01)。两组之间的住院时间、泌尿系统并发症和30天再入院率无显著差异。
虽然留置导尿管时也可以下床活动,但导尿管的存在仍然是VATS肺叶切除术患者早期活动的一个额外障碍。尽管我们在综合医疗系统中做出了其他促进早期活动的努力,但我们发现避免使用导尿管或在术后立即拔除导尿管与缩短首次下床活动时间相关。鉴于VATS肺叶切除术患者早期活动的已知益处,减少或省略导尿管可能为外科医生促进早期活动提供一个额外的工具。
减少导尿管留置时间与VATS肺叶切除术后TTA缩短相关。