Feasibility of Non-conventional Indwelling Catheter in Enhanced Recovery after Surgery of Gastric Cancer

  Objective  This study aimed to explore the feasibility of non-conventional indwelling catheter in enhanced recovery after surgery(ERAS) for postoperative patients with gastric cancer.

  Methods  The clinical data of patients undergoing gastric cancer radical surgery with ERAS were analyzed retrospectively in the Department of General Surgery, Nanjing General Hospital of Nanjing Military Region from June 2016 to March 2017. All catheters were inserted in the patients during the anesthesia induction period and removed immediately after surgery. The first time of urination after surgery, the volume, and the proportion of re-catheterization were recordedat the observing start point. The risk factors of the delay of the first urination and the reset of catheters were analy-zed.

  Results  In all 137 patients, there were 90 male (65.7%) and 47 female cases (34.3%) with an average age of (58.9±10.1)years. The first time of urination was (5.3±2.1) hours; the volume of the first urination was (298.9±101.3)ml; the incidence of resetting catheters was 11.7%(16/137). Subgroup analysis showed that the automatic urination rate was higher in the robotic surgery group. The induced urination rate, the incidence of resetting the urinary catheter, and the urinary tract irritation of the robotic surgery group were all lower compared with the open surgery group(all P < 0.05). 6-hour was used as the cutting line of the first postoperative urination time. Compared with the ≤ 6 h group, the >6 h group had more intraoperative infusion, urinary volume, and the first time of postoperative urine volume that delayed the first time of mobilization(all P < 0.01).

  Conclusion  sIt is feasible for patients with gastric cancer in ERAS to remove the urinary catheter immediately after surgery. Intraoperative control of infusion and multimodal analgesia are the basic conditions for non-conventional indwelling catheters. Robotic surgery is favorable for early postoperative recovery of automatic urination.