Jens Ravn Eriksen1, Pia Munk-Madsen2, Henrik Kehlet3, Ismail Gögenur2. 1. Colorectal Cancer Unit, Department of Surgery, Zealand University Hospital, Roskilde, Sygehusvej 10, 4000, Roskilde, Denmark. jeer@regionsjaelland.dk. 2. Colorectal Cancer Unit, Department of Surgery, Zealand University Hospital, Roskilde, Sygehusvej 10, 4000, Roskilde, Denmark. 3. Section for Surgical Pathophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: Early catheter removal is essential to enhance postoperative mobilization and recovery, but may carry a risk of urinary retention. This study aimed to evaluate a standardized regimen for early postoperative catheter removal and re-catheterization in patients undergoing elective laparoscopic colorectal cancer surgery within an optimal ERAS setting. METHODS: This was a single-center prospective study of patients undergoing elective minimally invasive colorectal resection and postoperative catheter removal within 24 h, with a re-catheterization threshold of 800 ml bladder volume. The primary outcome was postoperative urinary retention rate, and the secondary outcomes were time of catheter removal and length of stay with a special focus on differences between colon and rectal resections. RESULTS: A total of 113 patients were included in the study, and 87 patients were eligible for the final analysis. Rectal resection was performed in 22 of 87 patients, and all operations were performed with minimally invasive technique. The conversion rate was 3.5%, and 30-day mortality was 0%. More than 95% of the patients had their catheter removed within 24 h with no difference between rectal and colonic resections. Postoperative urinary retention was observed in 9% of all patients (rectum 18% vs. colon 6%, p = 0.11). One patient had an indwelling catheter at discharge, but all patients had free voluntary micturition at 30-day follow-up. Median length of stay was 3 days (1-13 days). CONCLUSIONS: Catheter removal within 24 h of surgery using a re-catheterization threshold of 800 ml is safe and reduces unnecessary re-catheterizations following minimally invasive colorectal resection.
BACKGROUND: Early catheter removal is essential to enhance postoperative mobilization and recovery, but may carry a risk of urinary retention. This study aimed to evaluate a standardized regimen for early postoperative catheter removal and re-catheterization in patients undergoing elective laparoscopic colorectal cancer surgery within an optimal ERAS setting. METHODS: This was a single-center prospective study of patients undergoing elective minimally invasive colorectal resection and postoperative catheter removal within 24 h, with a re-catheterization threshold of 800 ml bladder volume. The primary outcome was postoperative urinary retention rate, and the secondary outcomes were time of catheter removal and length of stay with a special focus on differences between colon and rectal resections. RESULTS: A total of 113 patients were included in the study, and 87 patients were eligible for the final analysis. Rectal resection was performed in 22 of 87 patients, and all operations were performed with minimally invasive technique. The conversion rate was 3.5%, and 30-day mortality was 0%. More than 95% of the patients had their catheter removed within 24 h with no difference between rectal and colonic resections. Postoperative urinary retention was observed in 9% of all patients (rectum 18% vs. colon 6%, p = 0.11). One patient had an indwelling catheter at discharge, but all patients had free voluntary micturition at 30-day follow-up. Median length of stay was 3 days (1-13 days). CONCLUSIONS: Catheter removal within 24 h of surgery using a re-catheterization threshold of 800 ml is safe and reduces unnecessary re-catheterizations following minimally invasive colorectal resection.
Authors: Joseph C Carmichael; Deborah S Keller; Gabriele Baldini; Liliana Bordeianou; Eric Weiss; Lawrence Lee; Marylise Boutros; James McClane; Liane S Feldman; Scott R Steele Journal: Dis Colon Rectum Date: 2017-08 Impact factor: 4.585
Authors: Mary R Kwaan; Janet T Lee; David A Rothenberger; Genevieve B Melton; Robert D Madoff Journal: Dis Colon Rectum Date: 2015-04 Impact factor: 4.585
Authors: Andres Guerra; Calvin Chao; Gabriel A Wallace; Heron E Rodriguez; Mark K Eskandari Journal: Ann Vasc Surg Date: 2021-10-20 Impact factor: 1.466
Authors: Patricia Tejedor; Santiago González Ayora; Mario Ortega López; Miguel León Arellano; Hector Guadalajara; Damián García-Olmo; Carlos Pastor Journal: Updates Surg Date: 2021-06-18
Authors: Stuart McIntosh; Ross Hunter; Duncan Scrimgeour; Mohammed Bekheit; Lynn Stevenson; George Ramsay Journal: Ann Med Surg (Lond) Date: 2021-12-13