Postoperative Urinary Complications in Head and Neck Free Flap Reconstructive Surgery.

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY Annals of Otology Rhinology and Laryngology Pub Date : 2024-03-01 Epub Date: 2023-10-30 DOI:10.1177/00034894231208256

Kimberly Chan, Allison Keane, Sandeep Pradhan, Tonya King, Annie Moroco, Neerav Goyal, Karen Y Choi

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Abstract

Objective: The purpose of this study is to evaluate the postoperative urinary complications and the optimal timing of foley catheter removal in patients who underwent free flap reconstructive surgery for head and neck pathology.

Methods: A retrospective case-control study of head and neck patients who underwent free flap reconstructive surgery at a single institution between January 2009 and December 2021 was conducted. Patient risk factors for postoperative urinary retention (POUR) were analyzed. Fisher Exact and Wilcoxon Rank Sum tests were used to evaluate rates of foley replacement, straight catheterization, and catheter-associated urinary tract infection (CAUTI) and associated risk factors.

Results: Two hundred and eleven patients were included in this study. Older age, lower BMI, lower intraoperative fluid volumes, and need for straight catheterization were statistically significant for POUR requiring foley replacement. Shorter total (P = .04) and postoperative (P = .01) foley duration showed statistical significance for POUR requiring straight catheterization. About 60% of patients who had straight catheterization required a foley replacement (P < .001). Only one patient (0.5%) developed a urinary tract infection (UTI).

Conclusion: Foley catheter duration impacts the risk of POUR requiring straight catheterization and subsequently, foley replacement. Optimal timing for foley catheter removal in the postoperative period remains to be elucidated. Removal of catheters between 21 and 48 hours after surgery may decrease the risk of POUR without increasing the rate of CAUTI in patients with head and neck pathology undergoing free flap reconstructive surgery.

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头颈部游离皮瓣重建术后尿路并发症。

目的：本研究的目的是评估接受头颈部病理学自由皮瓣重建手术的患者术后尿路并发症和移除foley导管的最佳时机。方法：对2009年1月至2021年12月在一家机构接受游离皮瓣重建手术的头颈部患者进行回顾性病例对照研究。分析患者术后尿潴留（POUR）的危险因素。Fisher Exact和Wilcoxon秩和检验用于评估foley置换术、直接导管插入术、导管相关性尿路感染（CAUTI）的发生率和相关风险因素。结果：211名患者被纳入本研究。年龄较大、BMI较低、术中液体量较低以及需要直接导管插入术对需要foley置换术的POUR具有统计学意义。较短总数（P = .04）和术后（P = .01）foley持续时间对于需要直接导管插入术的POUR显示出统计学意义。约60%的直接导管插入术患者需要进行foley置换术（P 结论：Foley导管持续时间影响POUR需要直接导管插入术和随后进行Foley置换的风险。术后取出foley导管的最佳时机仍有待阐明。移除21至48岁之间的导管在接受游离皮瓣重建手术的头颈部病理患者中，术后数小时可以降低POUR的风险，而不会增加CAUTI的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.