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间歇性尿道导管夹闭联合主动排尿训练(ICCAUT)策略对直肠癌根治术后排尿功能障碍的影响:单中心随机对照试验(ICCAUT -1)研究方案

Effect of intermittent urethral catheter clamping combined with active urination training (ICCAUT) strategy on postoperative urinary dysfunction after radical rectal cancer surgery: single-centre randomised controlled trial (ICCAUT -1) study protocol.

作者信息

He Tingting, Liang Sen, Guan Yunan, Sun Jianan, Hu Haiyan, Wang Quan, Guo Yuchen

机构信息

Department of Gastrocolorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, China.

Department of Gastrocolorectal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China.

出版信息

BMJ Open. 2025 Feb 5;15(2):e095217. doi: 10.1136/bmjopen-2024-095217.

Abstract

BACKGROUND

Urinary catheter placement is routinely performed after proctectomy. However, there is uncertainty regarding the need for bladder training before catheter removal. This trial aims to examine the effect of intermittent catheter clamping combined with active urination training (ICCAUT) on urinary retention and secondary catheterisation after proctectomy.

METHODS AND ANALYSIS

Eligible patients will be randomly assigned in a 1:1 ratio to either the ICCAUT group or the free-drainage (FD) group. In the ICCAUT group, patients will undergo intermittent clamping of the urinary catheter combined with active urination training before its removal, whereas the patients in the FD group will not receive any specific training. The urinary catheter will be removed on postoperative day 2 in both groups after emptying the bladder. The primary end point is the incidence of urinary dysfunction. Secondary end points include urinary tract infection, time to first urination after catheter removal, catheter-related bladder discomfort syndrome, postoperative morbidity and mortality and urinary function within 30 days.

ETHICS AND DISSEMINATION

This trial was approved by the Ethics Review Committee of the First Hospital of Jilin University (24K047-001). Written informed consent will be obtained before performing any study procedures. All primary and secondary outcomes will be reported in peer-reviewed publications and at conference presentations.

TRIAL REGISTRATION NUMBER

The trial was registered at ClinicalTrials.gov website, NCT06241703.

摘要

背景

直肠切除术后通常会留置导尿管。然而,在拔除导尿管前是否需要进行膀胱训练尚不确定。本试验旨在探讨间歇性导尿管夹闭联合主动排尿训练(ICCAUT)对直肠切除术后尿潴留及再次导尿的影响。

方法与分析

符合条件的患者将按1:1的比例随机分配至ICCAUT组或自由引流(FD)组。在ICCAUT组,患者在拔除导尿管前将接受间歇性导尿管夹闭联合主动排尿训练,而FD组患者将不接受任何特殊训练。两组患者均在术后第2天排空膀胱后拔除导尿管。主要终点是排尿功能障碍的发生率。次要终点包括尿路感染、拔除导尿管后首次排尿时间、导尿管相关膀胱不适综合征、术后发病率和死亡率以及30天内的排尿功能。

伦理与传播

本试验已获得吉林大学第一医院伦理审查委员会批准(24K047-001)。在进行任何研究程序前将获得书面知情同意书。所有主要和次要结果将在同行评审的出版物和会议报告中公布。

试验注册号

该试验已在ClinicalTrials.gov网站注册,NCT06241703。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b431/11800286/dd20f42f975a/bmjopen-15-2-g001.jpg

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