ObjectiveTo investigate the effect of suprapubic catheterization(SPC) by using central venous catheter (CVC) on the perioperative complications in middle and low rectal cancer surgery. MethodsThe clinical data of 141 patients with middle and low rectal cancer underwent operation in Shengjing Hospital of China Medical University from April 2012 to January 2015 were collected. There were 65 patients performed SPC by using CVC, 76 patients performed routine transurethral catheterization(TUC). The incidences of bacteriuria and urinary retention, recatheterization rate, duration of catheterization, and catheter-related pain were analyzed and compared between these two groups. Results①Compared with the TUC, the SPC by using CVC could significantly reduce the incidence of bacteriuria(P=0.002), espe-cially in female(P=0.006), ≥60 years old(P=0.001), low rectal cancer(P=0.003), open surgery(P=0.018), Miles(P=0.016), and Dixon(P=0.032).②There was no significant difference in the incidence of urinary retention(P=0.464) between the SPC by using CVC and the TUC.③Compared with the TUC, the SPC by using CVC could significantly reduce the inci-dence of recatheterization rate(P=0.001), especially in the patients with male(P=0.016), ≥60 years old(P=0.008), low rectal cancer(P=0.019), laparoscopic surgery(P=0.013), and Miles(P=0.037).④Compared with the TUC, the point of catheter-related pain was significantly lower in the SPC by using CVC(P=0.001), no matter males(P=0.005) or females(P=0.010), aged 60 years and older(P=0.023) or younger(P=0.034), middle rectal cancer(P=0.017) or low rectal cancer(P=0.046), open surgery(P=0.033) or laparoscopic surgery(P=0.021), Dixon(P=0.019) or Miles(P=0.035).⑤The duration of catheterization was similar between the SPC by using CVC and the TUC(P=0.597). ConclusionSPC by using CVC is a safer, more effective and more acceptable method of bladder drainage in middle and low rectal cancer surgery as compared with routine TUC.
Objective To investigate the safety and feasibility of preoperative non-indwelling catheter in primary unilateral total knee arthroplasty (TKA) without tourniquet . Methods From January 2016 to January 2017, a total of 60 patients undergoing primary unilateral TKA surgery were randomly divided into preoperative non-indwelling catheter group (group NIC, n=30) and indwelling catheter group (group IC, n=30) . The patients in group NIC were not retained catherter, and the patients in group IC were retained catherter. All patients did not use tourniquet. The time of first urination, the volume of first urination, and the occurrence of urine retention, urinary irritation symptoms and urinary tract infection of patients in two groups were analyzed. The incidence of venous thrombosis of the lower extremity was also recorded. Results There were statistical differences (P<0.05) between group NIC and group IC in the time of first urination [(3.2±0.6) vs. (4.5±1.8) hours] and urine volume [(262.5±29.4) vs. (391.6±50.2) mL], but there was no significant difference (P>0.05) between the two groups in urinary retention (6.7% vs. 16.7%), urinary tract irritation (33.3% vs. 23.3%), or urinary tract infection (0.0% vs. 16.7%). Conclusion Preoperative non-indwelling catheter in primary unilateral TKA without tourniquet is safe and feasible.
ObjectiveTo evaluate the risk factors for postoperative indwelling catheter following enhanced recovery after primary unilateral total knee arthroplasty (TKA) under general anesthesia.MethodsPatients who underwent primary unilateral TKA under general anesthesia between January 2017 and August 2018 were enrolled in the study. Among them, 205 patients who met the selection criteria were included in the study, and the clinical data were collected, including gender, age, body mass index, preoperative range of motion, Hospital for Special Surgery (HSS) score, American Society of Anesthesiologists (ASA) score, disease type, comorbidity, hemoglobin, hematocrit, blood volume, length of operation and operation time, whether to keep drainage after surgery, intraoperative blood loss, total blood loss, and preoperative, intraoperative, postoperative fluid infusions, and total fluid infusion on the day of surgery, urine volume on the day of surgery. Univariate analysis and logistic regression analysis were used to screen the risk factors for postoperative indwelling catheter. Length of stay and incidences of complications (intermuscular vein thrombosis, deep vein thrombosis, pulmonary embolism, incision swelling and exudation, electrolyte disorder, nausea and vomiting, and urinary tract infection) were compared between the patients with or without indwelling catheter.ResultsIndwelling catheter occurred in 41 (20%) of 205 patients. Single factor analysis showed that the influence factors were age, gender, keeping drainage after surgery, total fluid infusion and urine volume on the day of surgery (P<0.05). The multiple factors analysis showed that the males and more urine volume on the day of surgery were the significant risk factors for indwelling catheter after primary TKA (P<0.05). In addition, postoperative length of stay was shorter and the incidence of urinary tract infection was lower in non-indwelling catheter group than in indwelling catheter group, showing significant differences (P<0.05).ConclusionThe male patients with more urine on the day of surgery have higher risk for indwelling catheter after primary unilateral TKA under general anesthesia with an enhanced recovery program.
ObjectiveTo investigate the occurrence of indwelling urinary catheter in patients receiving thoracoscopic lobectomy and relevant risk factors.MethodsWe retrospectively reviewed the clinical data of the 737 patients who received thoracoscopic lobectomy in our hospital and analyzed the risk factors of indwelling urinary catheter during postoperative hospitalization using univariate analysis and multiple-variate logistic regression analysis between December 2018 and May 2019. There were 253 males and 484 females at median age of 57 (50, 64) years.ResultsA percentage of 14.4% (106/737) of the patients adopted postoperative indwelling urinary catheter. Univariate regression analysis showed that gender and postoperative bedridden time were risk factors for indwelling urinary catheter in the patients after thoracoscopic lobectomy (P<0.05). Multiple-variate logistic regression analysis showed that male gender (OR=2.018, 95% CI 1.316-3.096, P<0.001) and postoperative bedridden time >18 hours (OR=2.298, 95%CI 1.502-3.516, P<0.001) were the independent risk factors for indwelling urinary catheter.ConclusionMale gender and those with longer postoperative bedridden time are high-risk population to indwell urinary catheter. Positive measures should be taken to reduce the chance of indwelling urinary catheter.
ObjectiveTo explore the independent risk factors for postoperative retention of urinary catheters in the ward of lung tumor patients due to urinary retention under the concept of enhanced recovery after surgery (ERAS).MethodsSeventy-five patients with lung tumors who had urinary catheters left in the postoperative ward between June 2019 and August 2019 were selected as a case group, and 75 patients with lung tumors who did not have urinary catheters in the perioperative period as a control group. Independent risk factors for indwelling urinary catheters in the postoperative ward were screened by univariate and multiple-variate logistic stepwise regression analysis.ResultsThere were 45 males and 30 females in the case group with an average age of 55.33±10.78 years, 28 males and 47 females in the control group with an average age of 57.12±10.06 years. Univariate analysis showed that gender, operative time>2 h, intraoperative fluid volume≥1 200 mL, and fluid volume within 6 h of returning to the ward after surgery>1 200 mL were associated with the occurrence of indwelling urinary catheters in patients with lung tumors in postoperative wards (P<0.05). Multiple-variate logistic regression showed that male (OR=2.311, 95%CI 1.173-4.552, P=0.015), infusion volume within 6 h of returning to the ward after surgery>1 200 mL (OR=2.491, 95%CI 1.149-5.401, P=0.021) and intraoperative infusion volume≥1 200 mL (OR=2.105, 95%CI 1.022-4.340, P=0.044) were independent risk factors for postoperative retention of urinary catheters in patients with lung tumors.ConclusionThe occurrence of indwelling urinary catheter in lung tumor patients under the ERAS concept is the result of a combination of factors, and patients who are male, have infusion volume>1 200 mL within 6 h of returning to the ward after surgery, and have intraoperative infusion volume≥1 200mL are the high-risk group for postoperative ward indwelling urinary catheter, and health care personnel should strengthen the assessment and observation, provide targeted health education, appropriately control the perioperative fluid volume, and take other measures to reduce the occurrence of indwelling urinary catheters due to urinary retention postoperatively in ward.
ObjectiveTo systematically review the effect of clamping catheter and free drainage for patients with neurogenic bladder with indwelling catheter. MethodsThe PubMed, EMbase, CINAHL, EBSCO, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objects from inception to January 8, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 7 RCTs involving 586 patients were included. Meta-analysis showed that clamping catheter significantly reduced time of first void (SMD=−1.03, 95%CI −1.71 to −0.36, P=0.03) and increased volume of first void (MD=52.72, 95%CI 28.84 to 76.59, P<0.01). However, there was no significant difference in residual urine volume, incidence of urinary retention or urinary tract infection between the two groups. ConclusionCurrent evidence shows that the advantage of clamping catheter for patients with neurogenic bladder with indwelling catheter is not obvious. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.