Toshiyuki Enomoto, MD, Yoshihisa Saida, Prof, Sayaka Nagao, MD, Asako Takahashi, MD, Ryohei Watanabe, MD, Tadashi Higuchi, MD, Koji Asai, MD, Manabu Watanabe, MD, Shinya Kusachi, Prof. Department of Surgery, Toho University Ohashi Medical Center
Introduction: In Japan, transurethral balloon catheters (TUC) are currently inserted in most surgical patients to maintain a urine outflow route and to measure the urine output both intraoperatively and postoperatively. However, TUC insertion not only causes postoperative pain but can also lead to urinary tract infections. Temporary suprapubic catheters (SPC) are used in the field of obstetrics and gynecology as a method of postoperative management to avoid performing transurethral procedures. In the field of surgery, especially in laparoscopic surgery, SPC also considered how it would be a useful way to reduce patient suffering. Here we report our prospective study on whether an SPC can be safely inserted as a substitute for TUC during laparoscopic-assisted colectomy.
Subjects and Methods: The subjects in this study were patients who underwent laparoscopic surgery for primary colorectal cancer from 2014 to 2015, and who would normally have had their urinary balloon catheter removed early after surgery. During surgery, an Angiomed cystostomy set was installed for patients who gave their consent to participate in this study as an alternative to a urinary balloon catheter. We prospectively collected patient information including sex and age, in addition to other perioperative data, such as, time required for cystostomy, complications accompanying cystostomy, sense of discomfort or pain associated with the vesical fistula after surgery, the time of the removal of the vesical fistula, the frequency of releasing the vesical fistula, postoperative complications.
Results: Our subjects included 52 cases who gave their informed consent to have an SPC inserted. An SPC was inserted into the remaining 45 case. The mean surgical duration was 229 min, and the SPC insertion was performed at a mean of 137 min after the start of surgery. Insertion required a mean duration of 158.2 s. The bladder of one case (2.2%) was perforated, and hematuria was observed at the time of insertion in two cases (4.4%), but surgery completed without any incident. Six out of 42 cases (13.3%) demonstrated neither urinary urgency nor independent urination on the day the catheter was clamped. However, the clamp was released two to four times, and draining of an average of 586 mL urine, urinary urgency, and independent urination were confirmed 2–4 days later.
Conclusion: SPC is a procedure that avoids crossing the urethra and its associated disadvantages. Here we were able to demonstrate that the procedure can be safely used in laparoscopic surgery patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85487
Program Number: P720
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster