4.5 Article

Multicentre, prospective, randomized control non-inferiority trial of bladder catheter management in colon surgery

期刊

COLORECTAL DISEASE
卷 25, 期 7, 页码 1506-1511

出版社

WILEY
DOI: 10.1111/codi.16593

关键词

acute urine retention; bladder catheter; laparoscopic colon

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The aim of this study is to provide a rationale for reducing catheterization time while avoiding acute urine retention in patients undergoing scheduled laparoscopic colon surgery. The study is a multicenter, prospective, controlled, randomized non-inferiority study, with patients randomized into two groups: experimental group (with immediate catheter removal after surgery) and control group (with catheter removal 24 hours post-surgery). The main outcome is the development of acute urine retention, with secondary outcomes being urinary infection and hospital stay.
Aim: Perioperative bladder catheterization is a controversial issue. Most current recommendations are based on data from open surgery extrapolated to enhanced recovery after surgery or fast-track programmes ranging between 24 and 48 h. The aim of this study is to provide a rationale for reducing catheterization time while at the same time avoiding acute urine retention (AUR), in patients undergoing scheduled laparoscopic colon surgery. Method: This is a multicentre, prospective, controlled, randomized non-inferiority study of bladder catheter management in patients undergoing scheduled laparoscopic colon surgery, randomized into two groups: experimental (with catheter removal immediately after surgery) and control (with catheter removal 24 h post-surgery). The main outcome will be the development of AUR, and secondary outcomes the development of urinary infection within the first 30 days and hospital stay. Demographic, surgical and pathological variables will also be evaluated, especially the development of adverse effects assessed according to the Clavien scale and the Comprehensive Complication Index. Following the literature, we assume an incidence of AUR of 11% and a margin of non-inferiority (delta) of 8% and estimate that a sample size of 208 patients per group will be required (with an estimated 10% of losses per group). Conclusions: In this study we try to demonstrate that the bladder catheter can be removed immediately after scheduled laparoscopic colon surgery, without increasing acute urine retention. This measure would offers the benefits of earlier mobilization and reduces catheter-related morbidity.

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