Early removal or avoiding the use of perioperative indwelling urinary catheters with spontaneous pneumothorax surgery
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ORIGINAL ARTICLE
Early removal or avoiding the use of perioperative indwelling urinary catheters with spontaneous pneumothorax surgery Mizuki Morota1 · Takuma Yotsumoto1 · Shin Karita1 · Makoto Tanaka1 Received: 30 September 2020 / Accepted: 23 October 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Objectives The study evaluated the safety and advantages of no using urinary catheters (UCs) during the perioperative period in patients undergoing spontaneous pneumothorax surgery. Methods Forty-one patients aged 30 years or younger who underwent spontaneous pneumothorax surgery at our hospital between January 2018 and March 2020 were screened. Patients with postoperative recurrence were excluded. Patients were divided into three groups: the indwelling UC group (n = 10, group A), the group with UC removal in the operating room before extubation (n = 23, group B), and the no UC group (n = 8, group C). Perioperative circulatory complications, UC insertion or re-insertion, and time to getting out of bed after surgery and confirmation of initial urination were investigated by group. Results There were no perioperative UC insertions or re-insertions, or perioperative circulatory problems in any group. The median time (interquartile range) required for confirmation of initial postoperative urination was shorter in groups B and C [group A: 13.5 (10.6, 17.3) vs group B: 6.0 (5.0, 6.8) vs group C: 5.5 (3.8, 6.8) h; p = 0.01]. However, the time to getting out of bed after surgery was not significantly different [10.5 (6.4, 15) vs 6.0 (5.0, 7) vs 5.0 (3.8, 8) h; p = 0.12)]. Multivariable analysis showed that group A had a significantly different time to confirmation of initial urination (p = 0.001). Conclusions Postoperative and intraoperative avoidance of indwelling UC use is acceptable in spontaneous pneumothorax surgery that satisfies certain conditions. Avoiding UC use has the potential to improve the patient experience and facilitate postoperative management. Keywords Thoracic surgery · Spontaneous pneumothorax · Urinal catheter · Tube less surgery · Minimally invasive surgery
Introduction During thoracic surgery, indwelling urinary catheters (UCs) are routinely used for management of perioperative circulation and to allow patients who have difficulty in getting out of bed to have postoperative rest. However, the necessity of UC placement for relatively brief, low-risk surgery to treat spontaneous pneumothorax, which is common in young patients, is unclear. In addition, UCs are associated with a risk of complications such as urethral injury and urinary tract infection (UTI). In addition, the stress of UC placement and removal may hinder postoperative mobilization in young patients. * Mizuki Morota morota‑[email protected] 1
Some studies have shown that UC placement for monitoring perioperative urine output is not required [1, 2]. Yutian et al. reported a study about major lung resection for lung cancer without UC placement (n = 2495). They concluded that no UC use is safe and not a risk factor f
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