Systematic Early Urinary Catheter Removal Integrated in the Full Enhanced Recovery After Surgery (ERAS) Protocol After Laparoscopic Mid to Lower Rectal Cancer Excision: A Feasibility Study

Hélène Meillat; Cloé Magallon; Clément Brun; Cécile de Chaisemartin; Laurence Moureau-Zabotto; Julien Bonnet; Marion Faucher; Bernard Lelong

doi:10.3393/ac.2020.05.22

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저자정보: Hélène Meillat (Department of Digestive Surgical Oncology Institut Paoli Calmettes Marseille) Cloé Magallon (Department of Anesthesiology and Critical Care Institut Paoli Calmettes Marseille) Clément Brun (Department of Anesthesiology and Critical Care Institut Paoli Calmettes Marseille) Cécile de Chaisemartin (Department of Digestive Surgical Oncology Institut Paoli Calmettes Marseille) Laurence Moureau-Zabotto (Department of Radiation Therapy Institut Paoli Calmettes Marseille France) Julien Bonnet (Department of Digestive Surgical Oncology Institut Paoli Calmettes Marseille) Marion Faucher (Department of Anesthesiology and Critical Care Institut Paoli Calmettes Marseille) Bernard Lelong (Department of Digestive Surgical Oncology Institut Paoli Calmettes Marseille)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.37 No.4

발행연도: 2021.8

수록면: 204 - 211 (8page)

DOI: 10.3393/ac.2020.05.22

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Purpose: Enhanced Recovery After Surgery (ERAS) programs advocate early urinary catheter removal after rectal cancer surgery; however, the optimal duration remains unclear. This study assessed the feasibility of the early urinary catheter removal protocol after rectal cancer surgery within an ERAS pathway and identified predictive factors for failure of this strategy.Methods: Between March 2017 and October 2018, all unselected and consecutive patients who underwent rectal cancer resection and benefited from our ERAS program were included. Urinary complications (infection and retention) were prospectively recorded. Success was defined as catheter removal on postoperative day (POD) 3 without urinary complications.Results: Of 135 patients (male, 63.7%; neoadjuvant chemoradiation, 57.0%; urology history, 17.8%), 120 had early urinary catheter removal with no complications (success rate, 88.9%), 8 did not have urinary catheter removal on POD 3 due to clinical judgment or prescription error, 5 experienced a urinary tract infection, and 2 had acute urinary retention. Obesity (odds ratio [OR], 0.16; P = 0.003), American Society of Anesthesiologists physical status classification > II (OR, 0.28; P = 0.048), antiaggregant platelet medication (OR, 0.12; P < 0.001), absence of anastomosis (OR, 0.1; P = 0.003), and prolonged operative time (OR, 0.21; P = 0.020) were predictive factors for failure. Conversely, optimal compliance with the ERAS program (OR, 7.68; P < 0.001), postoperative nonsteroidal anti-inflammatory drug use (OR, 21.71; P < 0.001), and balanced intravenous fluid therapy (OR, 7.87; P = 0.001) were associated with increased strategy success.Conclusion: Withdrawal of the urinary catheter on POD 3 was successfully achieved after laparoscopic rectal resection and can be safely implemented in the ERAS program.

#Colorectal surgery #Surgical oncology #Enhanced Recovery After Surgery #Urinary retention

참고문헌 (26)

참고문헌 신청

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Garibaldi RA / 1974 / Factors predisposing to bacteriuria during indwelling urethral catheterization / N Engl J Med 291:215~219

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Stahl TJ / 2006 / Practice parameters for the prevention of venous thrombosis / Dis Colon Rectum 49:1477~1483

Nygren J / 2012 / Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations / Clin Nutr 31:801~816

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