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Trilling B, Tidadini F, Lakkis Z, Jafari M, Germain A, Rullier E, Lefevre J, Tuech JJ, Kartheuser A, Leonard D, Prudhomme M, Piessen G, Regimbeau JM, Cotte E, Duprez D, Badic B, Panis Y, Rivoire M, Meunier B, Portier G, Bosson JL, Vilotitch A, Foote A, Caspar Y, Rouanet P, Faucheron JL. Suprapubic versus transurethral catheterization for bladder drainage in male rectal cancer surgery (GRECCAR10), a randomized clinical trial. Tech Coloproctol 2024; 28:77. [PMID: 38954131 DOI: 10.1007/s10151-024-02950-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/25/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Bladder drainage is systematically used in rectal cancer surgery; however, the optimal type of drainage, transurethral catheterization (TUC) or suprapubic catheterization (SPC), is still controversial. The aim was to compare the rates of urinary tract infection on the fourth postoperative day (POD4) between TUC and SPC, after rectal cancer surgery regardless of the day of removal of the urinary drain. METHODS This randomized clinical trial in 19 expert colorectal surgery centers in France and Belgium was performed between October 2016 and October 2019 and included 240 men (with normal or subnormal voiding function) undergoing mesorectal excision with low anastomosis for rectal cancer. Patients were followed at postoperative days 4, 30, and 180. RESULTS In 208 patients (median age 66 years [IQR 58-71]) randomized to TUC (n = 99) or SPC (n = 109), the rate of urinary infection at POD4 was not significantly different whatever the type of drainage (11/99 (11.1%) vs. 8/109 (7.3%), 95% CI, - 4.2% to 11.7%; p = 0.35). There was significantly more pyuria in the TUC group (79/99 (79.0%) vs. (60/109 (60.9%), 95% CI, 5.7-30.0%; p = 0.004). No difference in bacteriuria was observed between the groups. Patients in the TUC group had a shorter duration of catheterization (median 4 [2-5] vs. 4 [3-5] days; p = 0.002). Drainage complications were more frequent in the SPC group at all followup visits. CONCLUSIONS TUC should be preferred over SPC in male patients undergoing surgery for mid and/or lower rectal cancers, owing to the lower rate of complications and shorter duration of catheterization. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02922647.
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Affiliation(s)
- B Trilling
- Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France
- TIMC-IMAG - CNRS UMR 5525, University Grenoble Alpes, 38000, Grenoble, France
| | - F Tidadini
- Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France
- Lyon Center for Innovation in Cancer, Lyon 1 University, EA 3738, Lyon, France
| | - Z Lakkis
- Department of Surgical Oncology, Besancon University Hospital, Besancon, France
| | - M Jafari
- Department of Digestive and Oncological Surgery, Oscar Lambret Center, Lille, France
| | - A Germain
- Digestive Surgery Department, University Hospital of Nancy, Nancy, France
| | - E Rullier
- Digestive Surgery Department, Bordeaux University Hospital, Bordeaux, France
| | - J Lefevre
- Digestive Surgery Department, Saint-Antoine Hospital, APHP, Paris, France
| | - J J Tuech
- Digestive Surgery Department, Rouen University Hospital, Rouen, France
| | - A Kartheuser
- Department of Medical Oncology, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - D Leonard
- Department of Medical Oncology, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - M Prudhomme
- Department of Digestive Surgery, Nîmes, University Hospital, Nîmes, France
| | - G Piessen
- Digestive Surgery Department, University Hospital of Lille, Lille, France
| | - J M Regimbeau
- Department of Digestive Surgery, Amiens University Hospital, Amiens, France
| | - E Cotte
- Digestive Surgery Department, Lyon-Sud University Hospital, Pierre-Bénite, France
| | - D Duprez
- Digestive Surgery Department, Annecy-Genevois Hospital, Metz-Tessy, France
| | - B Badic
- Department of General and Digestive Surgery, Brest, University Hospital, Brest, France
| | - Y Panis
- Department of Colorectal Surgery, Beaujon Hospital, AP-HP, Clichy, France
| | - M Rivoire
- Department of Surgical Oncology, Léon Bérard Center, Lyon, France
| | - B Meunier
- Department of Hepatobiliary and Digestive Surgery, Rennes University Hospital, Rennes, France
| | - G Portier
- Department of Digestive Surgery, Toulouse Purpan University Hospital, Toulouse, France
| | - J L Bosson
- Department of Medical Information, Grenoble-Alpes University Hospital, Grenoble, France
- Colorectal Unit, Department of Surgery, Hôpital Michallon, CHU de Grenoble-Alpes, CS 10217, 38043, Grenoble Cedex, France
| | - A Vilotitch
- Department of Medical Information, Grenoble-Alpes University Hospital, Grenoble, France
| | - A Foote
- Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France
| | - Y Caspar
- Laboratory of Bacteriology, Grenoble-Alpes University Hospital, Grenoble, France
| | - P Rouanet
- Surgical Oncology Department, Montpellier Cancer Institute (ICM), Montpellier, France
| | - J L Faucheron
- Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France.
- TIMC-IMAG - CNRS UMR 5525, University Grenoble Alpes, 38000, Grenoble, France.
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Yang H, Jiang P, Zhang Z, Liu J, Zhou Y, Li P, Zeng Q, Long Y, Zhang X, Sun Y. Early-stage voiding function following uni- versus bilateral inferior vesical vessel resection during therapeutic lateral lymph node dissection with autonomic nerve sparing for advanced low rectal cancer (with video). Wideochir Inne Tech Maloinwazyjne 2024; 19:223-232. [PMID: 38973788 PMCID: PMC11223555 DOI: 10.5114/wiitm.2024.140318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/21/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Lateral lymph node dissection (LLND) has now been widely accepted as the optimal procedure to minimize lateral local recurrence (LLR) for selected cases with advanced lower rectal cancer in Asian countries. However, there is still controversy over the preservation or resection of the inferior vesical vessels (IVVs) during LLND due to concerns of impaired post-operative urinary function. Moreover, the standardized procedure for autonomic nerve preservation has not yet been established. Aim To evaluate the early-stage postoperative voiding function in patients who underwent LLND with uni- versus bilateral resection of the IVVs and to introduce an autonomic nerve sparing technique with a fascial space priority approach (FSPA). Material and methods LLND was performed in 106 consecutive patients with advanced low rectal cancer at Tianjin Union Medical Center from May 2017 to October 2022. Prospectively collected clinical data were retrospectively compared between patients who received uni-lateral and bilateral LLND. A video with narration was provided to introduce the stepwise procedure of autonomic nerve preservation during IVV resection. Results The unilateral lymph node dissection (LND) group and the bilateral LND group included 75 and 31 cases, respectively. All LLNDs were performed with FSPA with IVV resection as a standard procedure. No significant differences were observed in overall catheterization days (p = 0.336) and re-catheterization rate (p = 0.575) between groups. No patients in either group suffered from long-term (≥ 30 days) voiding dysfunction. Conclusions Autonomic nerve sparing is achievable with resection of IVVs during LLND. Satisfactory early-stage voiding function could be obtained with IVV resection on both sides.
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Affiliation(s)
- Hongjie Yang
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | | | - Zhichun Zhang
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Jiafei Liu
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Yuanda Zhou
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Peng Li
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Qingsheng Zeng
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Yu Long
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Xipeng Zhang
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
| | - Yi Sun
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
- Nankai University, Tianjin, China
- Tianjin Institute of Coloproctology, Tianjin, China
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Lee C, Park IJ. Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes. World J Mens Health 2024; 42:304-320. [PMID: 38449456 PMCID: PMC10949018 DOI: 10.5534/wjmh.230335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 03/08/2024] Open
Abstract
Anatomical and physiological differences exist between sex, leading to variations in how diseases, such as rectal cancer, are prevalence and treatment outcomes of diseases including rectal cancer. In particular, in the case of rectal cancer, anatomical differences may be associated with surgical challenges, and these factors are believed to be important contributors to potential disparities in postoperative recovery, associated complications, and oncological outcomes between male and female patients. However, there is still ongoing debate regarding this matter. Significantly, the male pelvic anatomy is distinguished by its narrower dimensions, which can present surgical challenges and impede visual access during operative procedures, rendering it more complex than surgical interventions in the female pelvis. As a result, this anatomical difference leads to a greater occurrence of postoperative complications, such as anastomotic leakage. Moreover, the pelvis houses nerves that are vital for urinary and genital functions, underscoring the need to assess the potential risks of sexual and urinary dysfunction in rectal cancer surgery. These postoperative complications can significantly impact the quality of life; therefore, it is imperative to perform surgery with an understanding of the structural differences between sexes. Therefore, to address the limitations imposed by anatomical structures, new approaches such as robotic surgery, trans-anal total mesorectal excision, and intraoperative neuromonitoring are being introduced. Furthermore, it is essential to conduct research into fundamental mechanisms that may give rise to differences in surgical outcomes and oncological results between sexes. By comprehending the disparities between males and females, we can advance toward personalized treatments. Consequently, this review outlines variations in surgical approaches, complications, and treatments for rectal cancer in male and female patients.
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Affiliation(s)
- Chungyeop Lee
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Ja Park
- Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Kim IK, Lee CS, Bae JH, Han SR, Alshalawi W, Kim BC, Lee IK, Lee DS, Lee YS. Perioperative outcomes of laparoscopic low anterior resection using ArtiSential ® versus robotic approach in patients with rectal cancer: a propensity score matching analysis. Tech Coloproctol 2024; 28:25. [PMID: 38231341 DOI: 10.1007/s10151-023-02895-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Total mesorectal excision using conventional straight fixed devices may be technically difficult because of the narrow and concave pelvis. Several laparoscopic articulating tools have been introduced as an alternative to robotic systems. The aim of this study was to compare perioperative outcomes between laparoscopic low anterior resection using ArtiSential® and robot-assisted surgery for rectal cancer. METHODS This retrospective study included 682 patients who underwent laparoscopic or robotic low anterior resection for rectal cancer from September 2018 to December 2021. Among them, 82 underwent laparoscopic surgery using ArtiSential® (group A) and 201 underwent robotic surgery (group B). A total of 73 [group A; 66.37 ± 11.62; group B 65.79 ± 11.34] patients were selected for each group using a propensity score matching analysis. RESULTS There was no significant difference in the baseline characteristics between group A and B. Mean operative time was longer in group B than A (163.5 ± 61.9 vs 250.1 ± 77.6 min, p < 0.001). Mean length of hospital stay was not significantly different between the two groups (6.2 ± 4.7 vs 6.7 ± 6.1 days, p = 0.617). Postoperative complications, reoperation, and readmission within 30 days after surgery were similar between the two groups. Pathological findings revealed that the circumferential resection margins were above 10 mm in both groups (11.00 ± 7.47 vs 10.17 ± 6.25 mm, p = 0.960). At least 12 lymph nodes were sufficiently harvested, with no significant difference in the number harvested between the groups (20.5 ± 9.9 vs 19.7 ± 7.3, p = 0.753). CONCLUSIONS Laparoscopic low anterior resection using ArtiSential® can achieve acceptable clinical and oncologic outcomes. ArtiSential®, a multi-joint and articulating device, may serve a feasible alternative approach to robotic surgery in rectal cancer.
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Affiliation(s)
- I K Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - C S Lee
- Department of Colorectal Surgery, Hansol Hospital, Seoul, Republic of Korea
| | - J H Bae
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S R Han
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - W Alshalawi
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Surgery, King Saud Medical City, Riyadh, Saudi Arabia
| | - B C Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - I K Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - D S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y S Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Buzzi G, Antonello M, Scognamiglio F, De Simoni O, Spolverato G, Pilati P, Pucciarelli S, Angriman I, Scarpa M, Castagliuolo I. Predictors of urinary tract infection after lower gastrointestinal surgery. Langenbecks Arch Surg 2023; 408:342. [PMID: 37642738 DOI: 10.1007/s00423-023-03064-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Urinary tract infections (UTIs) cause postoperative morbidity in patients undergoing lower gastrointestinal (GI) surgery that can prolong postoperative hospital stays. In patients with a fever of unknown origin (FUO), clinicians ignore what to do while waiting for the results of the urine culture test. This study aimed to develop a nomogram predicting UTI in the case of postoperative FUO. METHODS This observational, retrospective study included all consecutive patients from 1 November 2020 to 1 November 2021 undergoing lower-GI surgery at the Chirurgia Generale 3, University Hospital of Padua, Italy. A nomogram was created and externally validated in 90 consecutive patients undergoing urine culture tests for FUO at the Chirurgia Oncologica Unit, Veneto Institute of Oncology. RESULTS In the development cohort, 109 (N = 109) patients performed a urine culture test for FUO, and 39 were diagnosed with UTI. In a multivariate analysis of patients who underwent urine culture tests for FUO, UTI was associated with female sex, older age, and duration of catheterization at the date of the urine culture test. We developed a nomogram to predict UTI in surgical patients with a C-index of 0.76. In the validation cohort, 90 consecutive patients, who had lower-GI surgery, underwent a urine culture test for FUO and were tested with this nomogram. In the validation cohort, the C-index of the nomogram for predicting a positive urine culture test was 0.71. CONCLUSIONS AND RELEVANCE UTIs are a common problem in patients undergoing lower-GI surgery. A nomogram including the major risk factors may help to reduce the inappropriate use of antibiotics during the period awaiting the result of the urine culture test.
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Affiliation(s)
- Gianluca Buzzi
- Chirurgia Generale 3, Padua University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Maria Antonello
- Department of Molecular Medicine, University of Padua and Microbiology Unit, Padua University Hospital, Padova, Italy
| | - Federico Scognamiglio
- Chirurgia Generale 3, Padua University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Ottavia De Simoni
- Chirurgia Oncologica Unit, Veneto Institute of Oncology, Castelfranco Hospital, Treviso, Italy
| | - Gaya Spolverato
- Chirurgia Generale 3, Padua University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Pierluigi Pilati
- Chirurgia Oncologica Unit, Veneto Institute of Oncology, Castelfranco Hospital, Treviso, Italy
| | - Salvatore Pucciarelli
- Chirurgia Generale 3, Padua University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Imerio Angriman
- Chirurgia Generale 3, Padua University Hospital, Via Giustiniani 2, 35128, Padova, Italy
| | - Marco Scarpa
- Chirurgia Generale 3, Padua University Hospital, Via Giustiniani 2, 35128, Padova, Italy.
| | - Ignazio Castagliuolo
- Department of Molecular Medicine, University of Padua and Microbiology Unit, Padua University Hospital, Padova, Italy
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Kim IK, Lee CS, Bae JH, Han SR, Lee DS, Lee IK, Lee YS. Immediate urinary catheter removal after colorectal surgery with the enhanced recovery after surgery protocol. Int J Colorectal Dis 2023; 38:162. [PMID: 37284881 DOI: 10.1007/s00384-023-04460-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE The Enhanced Recovery After Surgery protocol for colorectal surgery recommends early urinary catheter (UC) removal after surgery. However, the optimal timing remains controversial. We aimed to evaluate the safety of immediate UC removal and risk factors of postoperative urinary retention (POUR) after colorectal cancer surgery. METHODS From November 2019 and April 2022, patients who underwent elective colorectal cancer surgery at Seoul St. Mary's hospital were collected retrospectively. A UC was inserted in the operating room after general anesthesia and removed in the operating room immediately after surgery. The primary outcome was the occurrence of POUR following immediate UC removal after surgery, and the secondary outcomes were the identification of POUR-related risk factors and postoperative complications. RESULTS Among 737 patients, 81 (10%) had POUR immediately after UC removal. No patient had urinary tract infection. The incidence of POUR was significantly higher in male and in those with a history of urinary disease. However, there were no significant differences in tumor location, surgical procedure, or approach. The mean operative time was significantly longer in the POUR group. Postoperative morbidity and mortality rates did not differ significantly between two groups. Multivariate analysis showed that risk factors for POUR were male, a history of urinary disease, and intrathecal morphine injection. CONCLUSIONS Immediate removal of UC immediately after colorectal surgery is safe and feasible in the trend of ERAS. Male, a history of benign prostatic hyperplasia, and intrathecal morphine injection were risk factors for POUR.
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Affiliation(s)
- In Kyeong Kim
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Chul Seung Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jung Hoon Bae
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Seung Rim Han
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Do Sang Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - In Kyu Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yoon Suk Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Lee J. The Optimal Time for Urinary Catheter Removal in Enhanced Recovery After Surgery (ERAS) Protocol After Laparoscopic Rectal Cancer Surgery: When and How? Ann Coloproctol 2021; 37:193-194. [PMID: 34433240 PMCID: PMC8391041 DOI: 10.3393/ac.2021.00668.0095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 12/05/2022] Open
Affiliation(s)
- Jaeim Lee
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Zhang L, Yang X, Tian Y, Yu Q, Xu Y, Zhou D, Wu Z, Zhao X. The feasibility and advantages of immediate removal of urinary catheter after lobectomy: A prospective randomized trial. Nurs Open 2021; 8:2942-2948. [PMID: 34329541 PMCID: PMC8510769 DOI: 10.1002/nop2.1006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/05/2021] [Accepted: 07/10/2021] [Indexed: 11/19/2022] Open
Abstract
Aim This study aims to evaluate the feasibility and advantages of immediate urinary catheter removal compared with prolonged indwelling catheterization in lung cancer lobectomy. Design This study was designed as a prospective, single‐centre, randomized and open‐label clinical study. Methods People with lung cancer undergoing lobectomy/pneumonectomy were recruited and randomly allocated to two groups. One group had their urinary catheter removed immediately while the other group had it removed 48 hr after surgery. Results No significant difference in the incidence of postoperative urinary retention (POUR) was observed between the two groups. However, the incidence of postoperative catheter‐associated urinary tract infection (CAUTI) in the immediate removal group (6.7%) was lower than the control group (17.2%) (p = .030). Furthermore, the incidence of catheter‐associated emergence agitation (CAEA) in the control group (25.3%) was higher than the immediate removal group (8.9%) (p = .007). The average length of hospital stay of the immediate removal group [6.51(4–11) days] was shorter than the control group [7.20(5–12) days] (p = .002). Immediate removal of urinary catheter appeared to have fewer complications and shorter hospital stay than delayed removal.
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Affiliation(s)
- Lei Zhang
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xueying Yang
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Ye Tian
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Qian Yu
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Yang Xu
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Di Zhou
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhuo Wu
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xitong Zhao
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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