Cost-effectiveness Analysis of Perioperative No Indwelling Urinary Catheter in Lung Cancer Patients with Pulmonary Lobectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

Keywords：

Indwelling urinary catheter; Cost-effectiveness; Lung cancer surgery

DOI：

10.7507/1007-4848.20160100

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Objective To investigate cost-effectiveness of no indwelling urinary catheter in pulmonary lobectomy patients and to confirm the advances of no indwelling urinary catheter. Methods We recruited 148 lung cancer patients who were scheduled for pulmonary lobectomy under general anesthesia in West China Hospital from July through December 2015. These patients were divided into two groups including an indwelling urinary catheter group (74 patients, 45 males and 29 females, at age of 52.55±19.87 years) and a no indwelling urinary catheter group (74 patients, 42 males and 32 females, at age of 54.03±16.66 years). Indexes of cost-effectiveness of the two groups were compared. Results There was no statistical difference between the two groups in duration of indwelling catheter (1.56±0.0.65 d versus 1.68±0.91 d, P=0.077). Material expense(4 811.48 yuan versus 296.74 yuan, P=0.045), cost of nursing care (7 413.32 yuan versus 457.32 yuan, P=0.013), and total expense (12 224.8 yuan versus 754.06 yuan, P=0.000) in the indwelling catheter group were higher than those in the no indwelling catheter group. Material expense per patient (65.02±5.62 yuan/patient-time versus 4.01±0.00 yuan/patient-time, P=0.000), cost of nursing care per patient (100.18±7.19 yuan/patient-time versus 6.18±1.22 yuan/patient-time, P=0.000), and total cost per patient (165.20±12.81 yuan/patienttime versus 10.19±1.22 yuan/patient-time, P=0.000) in the indwelling catheter group were higher than those in the no indwelling catheter group. Conclusion Both costs and labor of nurse can be cut down for appropriate lung cancer patients undergoing lobectomy without routine indwelling urinary catheter.

Citation： YANGMei, CHENJuan, CHEGuo-wei, QIUFang, WANGWei, LINLin, LIULun-xu. Cost-effectiveness Analysis of Perioperative No Indwelling Urinary Catheter in Lung Cancer Patients with Pulmonary Lobectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(5): 421-424. doi: 10.7507/1007-4848.20160100 Copy

1.	车国卫, 李为民, 刘伦旭. 快速肺康复需要围手术期流程优化. 中国胸心血管外科临床杂志, 2016, 23(3): 216-220.
2.	车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
3.	Shah RD, D'Amico TA. Modern impact of video assisted thoracic surgery. J Thorac Dis, 2014, 6(Suppl 6): S631-S636.
4.	邱舫, 杨梅, 王维, 等. 肺叶切除术后患者无尿管留置的前瞻性队列研究. 中国胸心血管外科临床杂志, 2015, 22(7): 634-637.
5.	徐志华, 杨梅, 邱舫, 等. 肺癌患者围手术期无痛性留置导尿的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 323-327.
6.	Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
7.	Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
8.	韩兆杰, 宋志芳, 苏建华, 等. 单胸腔引流管在肺癌术后快速康复中的应用. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
9.	杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后16F较28F胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
10.	Nanavati AJ, Prabhakar S. Fast-track surgery: Toward comprehensive peri-operative care. Anesth Essays Res, 2014, 8(2): 127-133.
11.	Yoo BE, Kye BH, Kim HJ, et al. Early removal of the urinary catheter after total or tumor-specific mesorectal excision for rectal cancer is safe. Dis Colon Rectum, 2015, 58(7): 686-691.
12.	Hollingsworth JM, Rogers MA, Krein SL, et al. Determining the noninfectious complications of indwelling urethral catheters: a systematic review and meta-analysis. Ann Intern Med, 2013, 159(6): 401-410.
13.	Greer SF, Sethi AK, Hecker MT, et al. Survey of patients' knowledge and opinions regarding the use of indwelling urinary catheters. Infect Control Hosp Epidemiol, 2011, 32(2): 174-176.
14.	Nicolle LE. Urinary catheter-associated infections. Infect Dis Clin North Am, 2012, 26(1): 13-27.
15.	Kamdar A, Yahya A, Thangaraj L. Retrospective observational study of the incidence of short-term indwelling urinary catheters in elderly patients with neck of femur fractures. Geriatr Gerontol Int, 2009, 9(2): 131-134.
16.	Kwaan MR, Lee JT, Rothenberger DA, et al. Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Dis Colon Rectum, 2015, 58(4): 401-405.
17.	Feneley RC, Hopley IB, Wells PN. Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol, 2015, 39(8): 459-470.
18.	赵金兰, 邱姝婷, 许宁惠, 等. 尿管留置对胸科手术患者全身麻醉苏醒期躁动影响的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 315-318.
19.	邱舫, 杨梅, 车国卫, 等. 胸腔镜肺叶切除术患者围手术期无尿管导致尿潴留的高危因素. 中国胸心血管外科临床杂志, 2016, 23(4): 328-333.
20.	Sánchez Villar I. Removal of short-term indwelling urethral catheters. Nurs Stand, 2008, 22(22): 42-45.

1. 车国卫, 李为民, 刘伦旭. 快速肺康复需要围手术期流程优化. 中国胸心血管外科临床杂志, 2016, 23(3): 216-220.
2. 车国卫, 刘伦旭, 石应康. 加速康复外科临床应用现状与思考. 中国胸心血管外科临床杂志, 2016, 23(3): 211-215.
3. Shah RD, D'Amico TA. Modern impact of video assisted thoracic surgery. J Thorac Dis, 2014, 6(Suppl 6): S631-S636.
4. 邱舫, 杨梅, 王维, 等. 肺叶切除术后患者无尿管留置的前瞻性队列研究. 中国胸心血管外科临床杂志, 2015, 22(7): 634-637.
5. 徐志华, 杨梅, 邱舫, 等. 肺癌患者围手术期无痛性留置导尿的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 323-327.
6. Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
7. Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
8. 韩兆杰, 宋志芳, 苏建华, 等. 单胸腔引流管在肺癌术后快速康复中的应用. 中国胸心血管外科临床杂志, 2014, 21(1): 17-20.
9. 杨梅, 樊骏, 周红霞, 等. 胸腔镜肺癌肺叶切除术后16F较28F胸腔引流管应用的临床优势. 中国肺癌杂志, 2015, 18(8): 512-517.
10. Nanavati AJ, Prabhakar S. Fast-track surgery: Toward comprehensive peri-operative care. Anesth Essays Res, 2014, 8(2): 127-133.
11. Yoo BE, Kye BH, Kim HJ, et al. Early removal of the urinary catheter after total or tumor-specific mesorectal excision for rectal cancer is safe. Dis Colon Rectum, 2015, 58(7): 686-691.
12. Hollingsworth JM, Rogers MA, Krein SL, et al. Determining the noninfectious complications of indwelling urethral catheters: a systematic review and meta-analysis. Ann Intern Med, 2013, 159(6): 401-410.
13. Greer SF, Sethi AK, Hecker MT, et al. Survey of patients' knowledge and opinions regarding the use of indwelling urinary catheters. Infect Control Hosp Epidemiol, 2011, 32(2): 174-176.
14. Nicolle LE. Urinary catheter-associated infections. Infect Dis Clin North Am, 2012, 26(1): 13-27.
15. Kamdar A, Yahya A, Thangaraj L. Retrospective observational study of the incidence of short-term indwelling urinary catheters in elderly patients with neck of femur fractures. Geriatr Gerontol Int, 2009, 9(2): 131-134.
16. Kwaan MR, Lee JT, Rothenberger DA, et al. Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Dis Colon Rectum, 2015, 58(4): 401-405.
17. Feneley RC, Hopley IB, Wells PN. Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol, 2015, 39(8): 459-470.
18. 赵金兰, 邱姝婷, 许宁惠, 等. 尿管留置对胸科手术患者全身麻醉苏醒期躁动影响的前瞻性队列研究. 中国胸心血管外科临床杂志, 2016, 23(4): 315-318.
19. 邱舫, 杨梅, 车国卫, 等. 胸腔镜肺叶切除术患者围手术期无尿管导致尿潴留的高危因素. 中国胸心血管外科临床杂志, 2016, 23(4): 328-333.
20. Sánchez Villar I. Removal of short-term indwelling urethral catheters. Nurs Stand, 2008, 22(22): 42-45.

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