背景:腹股沟疝修补术(IHR)是世界范围内常见的外科手术。虽然IHR可以通过微创方法进行,加速复苏,术后尿潴留(POUR)仍然是对患者有显著影响的常见并发症.因此,必须确定与POUR相关的风险因素,以减少其负面影响。
方法:我们对2018年至2021年的选修IHR进行了单中心回顾性审查。POUR定义为术后使用直导管或放置留置导管以缓解症状。进行了调整后的多元回归分析,以解决临床人口学,外科,以及POUR的术中因素。
结果:在排除紧急手术病例后,共有946名受试者被纳入分析,复发性疝,或伴随的操作。中位年龄为68.4岁,92.0%的患者为男性。23例(2.4%)患者出现POUR。在单变量分析中,与非POUR相比,POUR与年龄增加显着相关(72.2岁对68.3岁,P=0.012),更大量的术中液体(500对400毫升,P=0.040),诊断为良性前列腺肥大(34.8%对16.9%,P=0.025)。在多变量模型中,年龄增加(比值比[OR]1.04,95%CI1.01-1.08;P=0.049)和术中液体用量增加(每100mL增加1.12,95%CI1.01-1.27;P=0.047)与POUR的发生显着相关。
结论:我们发现年龄增加和术中液体用量增加与POUR的发生显著相关。限制术中液体的给药可以预防POUR。从实际意义的角度来看,对于液体管理和患者评估,应实施特定的指南或临床路径.
BACKGROUND: Inguinal hernia repair (IHR) is a common surgical procedure worldwide. Although IHR can be performed by the minimally invasive method, which accelerates recovery, postoperative urinary retention (POUR) remains a common complication that significantly impacts patients. Thus, it is essential to identify the risk factors associated with POUR to diminish its negative impact.
METHODS: We conducted a single-center retrospective review of elective IHR from 2018 to 2021. POUR was defined as the postoperative use of straight catheter or placement of an indwelling catheter to relieve the symptoms. Adjusted multivariate regression analysis was performed to address the associations of clinicodemographic, surgical, and intraoperative factors with POUR.
RESULTS: A total of 946 subjects were included in the analysis after excluding cases of emergent surgery, recurrent hernia, or concomitant operations. The median age was 68.4 years, and 92.0% of the patients were male. Twenty-three (2.4%) patients developed POUR. In univariate analysis, POUR in comparison with non-POUR was significantly associated with increased age (72.2 versus 68.3 years, P = 0.012), a greater volume of intraoperative fluid administered (500 versus 400 ml, P = 0.040), and the diagnosis with benign prostate hypertrophy (34.8% versus 16.9%, P = 0.025). In the multivariate model, both increased age (odds ratio [OR] 1.04, 95% CI 1.01-1.08; P = 0.049) and a greater volume of intraoperative fluid administered (OR 1.12 per 100-mL increase, 95% CI 1.01-1.27; P = 0.047) were significantly associated with the occurrence of POUR.
CONCLUSIONS: We found that increased age and a greater volume of intraoperative fluid administered were significantly associated with the occurrence of POUR. Limiting the administration of intraoperative fluid may prevent POUR. From the perspective of practical implications, specific guidelines or clinical pathways should be implemented for fluid management and patient assessment.