Early catheter removal after laparoscopic colonic resection: A propensity score matched analysis

Abstract

Background: The actual impact of early urinary catheter (UC) removal within an ERAS protocol after minimally invasive colonic resection (MICR) was assessed in a propensity score matched cohort.Methods: A retrospective cohort study was conducted on 227 consecutive patients who underwent elective MICR and ERAS were divided in two groups according to early (E-UC) or late (L-UC) removal of UC. After application of propensity score matching, two groups of 76 patients each were compared for non-severe post-operative complications, total fluids administered (TVF) and length of stay (LOS). Recovery outcomes, urinary retention (UR) and urinary tract infections (UTI) were the secondary endpoints analysed.Results: The L-UC was characterized by a higher TVF and an increased rate of general complications. Post-operative LOS was one day shorter in the E-UC group, whilst UR and UTI rates were comparably low. Late UC removal was associated to a delayed deambulation and solid diet intake.Conclusions: Our data confirm that early UC removal after MICR is safe and effective in reducing minor complications and LOS. Delay in UC removal is associated with an increased amount of post-operative fluids infusion and delayed restore of deambulation and solid diet intake which could be responsible for higher general complication rate. Avoidance of UC in selected patients should be further investigated.