Impact of Urinary Catheterization on Postoperative Outcomes After Roux-En-Y Gastric Bypass Surgery in Propensity-Matched Cohorts

2021 ◽  
pp. 000313482110234
Author(s):  
Derek D. Berglund ◽  
David M. Parker ◽  
Marcus Fluck ◽  
James Dove ◽  
Alexandra Falvo ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Operating Room ◽  
Urinary Catheter ◽  
Postoperative Outcomes ◽  
Urinary Catheters ◽  
Readmission Rates ◽  
Delayed Discharge ◽  
The Impact ◽  
Room Time ◽  
Operating Room Time

Background The impact of urinary catheter avoidance in bariatric enhanced recovery after surgery (ERAS) protocols is yet to be established. The purpose of the current study is to determine whether urinary catheter use in patients undergoing Roux-en-Y gastric bypass (RYGB) procedures has an effect on postoperative outcomes. Methods An institutional database was utilized to identify adult patients undergoing primary minimally invasive RYGB surgery. Outcomes included incidence of urinary tract infection (UTI) within 30 days postoperatively, 30-day readmission rates, proportion of patients discharged after postoperative day 1 (delayed discharge), length of stay (LOS), and operating room time. These were compared between propensity-matched groups with and without urinary catheter placement. Results There were no significant differences in postoperative UTI’s (2.2% for both cohorts, P = .593) or 30-day readmission rates for patients with and without urinary catheters (6.6% and 4.4%, respectively, P = .260). Mean LOS (1.7 vs. 1.5 days, P = .001) and the proportion of patients having a delayed discharge (47.3% vs. 33.7%, P = .001) was greater in patients with a catheter. Operating room time was longer in the urinary catheter group (221.8 vs. 207.9 minutes, P = .002). Discussion Avoidance of indwelling urinary catheters in RYGB surgical patients decreased delayed discharges and LOS without affecting readmission or reoperation rates. Therefore, we recommend that avoidance of urinary catheters in routine RYGB surgery be considered for inclusion into standardized ERAS protocols. Urinary catheters should continue to be utilized in select cases, however, as these were not shown to affect rate of UTIs.

1107: The Impact of Sugammadex on Operating Room Time in Living Donor Hepatectomy

2020 ◽  
Vol 49 (1) ◽  
pp. 555-555
Author(s):  
Gabriela Young ◽  
David Quan ◽  
Kendall Gross ◽  
Anthony Wong
Keyword(s):  
Operating Room ◽  
Living Donor ◽  
Donor Hepatectomy ◽  
Living Donor Hepatectomy ◽  
The Impact ◽  
Room Time ◽  
Operating Room Time

The impact of BMI on operating room time, blood loss, and hospital stay in patients undergoing spinal fusion

2019 ◽  
Vol 179 ◽  
pp. 19-22 ◽  
Author(s):  
Alan Villavicencio ◽  
E. Lee Nelson ◽  
Sharad Rajpal ◽  
Niketna Vivek ◽  
Sigita Burneikiene
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Spinal Fusion ◽  
Operating Room ◽  
The Impact ◽  
Room Time ◽  
Operating Room Time

scholarly journals Implementation of a Female External Urinary Catheter Reduces Indwelling Urinary Catheter Use and Catheter-Associated Urinary Tract Infections

2020 ◽  
Vol 41 (S1) ◽  
pp. s482-s483
Author(s):  
Paul Gentile ◽  
Jesse Jacob ◽  
Shanza Ashraf
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Improve Patient Safety ◽  
Academic Medical Center ◽  
Secondary Outcome ◽  
Successful Implementation ◽  
Urinary Catheters ◽  
Tract Infections ◽  
The Impact

Background: Using alternatives to indwelling urinary catheters plays a vital role in reducing catheter-associated urinary tract infections (CAUTIs). We assessed the impact of introducing female external catheters on urinary catheter utilization and CAUTIs. Methods: In a 500-bed academic medical center, female external catheters were implemented on October 1, 2017, with use encouraged for eligible females with urinary incontinence but not meeting other standard indications for urinary catheters. Nurses were educated and trained on female external catheter application and maintenance, and infection prevention staff performed surveillance case reviews with nursing and medical staff. We determined the number of catheter days for both devices based on nursing documentation of device insertion or application, maintenance, and removal. We used the CAUTI and DUR (device utilization ratio) definitions from the CDC NHSN. Our primary outcomes were changes in DUR for both devices 21 months before and 24 months after the intervention in both intensive care units (ICUs) and non-ICU wards. We used a generalized least-squares model to account for temporal autocorrelation and compare the trends before and after the intervention. Our secondary outcome was a reduction in CAUTIs, comparing females to males. Results: In total, there were 346,213 patient days in 35 months. The mean rate of patient days per month increased from 7,436.4 to 7,601.9 after the implementation of female external catheters, with higher catheter days for both urinary catheters (18,040 vs 19,625) and female external catheters (22 vs 12,675). After the intervention, the DUR for female external catheters increased (0 vs 0.07; P < .001) and for urinary catheters the DUR decreased (0.12 vs 0.10; P < .001) (Fig. 1). A reduction in urinary catheter DUR was observed in ICUs (0.29 vs 0.27; P < .001) but not wards (0.08 vs 0.08; P = NS) (Fig. 2). Of the 39 CAUTIs, there was no significant overall change in the rate per 1,000 catheter days (1.22 vs 0.87; P = .27). In females (n = 20 CAUTI), there was a 61% reduction in the CAUTI rate per 1,000 catheter days (0.78 vs 0.31; P = .02), but no significant change in the rate in males (0.44 vs 0.56; P = .64). The CAUTI rate per 1,000 catheter days among females decreased in the ICUs (1.14 vs 0.31; P = .04) but not in wards (0.6 vs 0.33; P = .96). Conclusions: In a setting with a baseline low UC DUR, successful implementation of female external catheters further modestly reduced UC DUR and was associated with a 61% decrease in CAUTI among females in the ICU but not in wards. Further interventions to better identify appropriate patients for female external catheters may improve patient safety and prevent patient harm.Funding: NoneDisclosures: None

Is Robot Assistance Affecting Operating Room Time Compared with Pure Retroperitoneal Laparoscopic Radical Prostatectomy?

2009 ◽  
Vol 23 (6) ◽  
pp. 939-943 ◽  
Author(s):  
Guillaume Ploussard ◽  
Evanguelos Xylinas ◽  
Alexandre Paul ◽  
Norman Gillion ◽  
Laurent Salomon ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Operating Room ◽  
Laparoscopic Radical Prostatectomy ◽  
Robot Assistance ◽  
Room Time ◽  
Operating Room Time

Intraoperative computed tomography registration and electromagnetic neuronavigation for transsphenoidal pituitary surgery: accuracy and time effectiveness

2011 ◽  
Vol 114 (2) ◽  
pp. 329-335 ◽  
Author(s):  
Paula Eboli ◽  
Bob Shafa ◽  
Marc Mayberg
Keyword(s):  
Mr Imaging ◽  
Operating Room ◽  
Navigation System ◽  
Surgical Techniques ◽  
Imaging Data ◽  
3D Navigation ◽  
Closure Time ◽  
Bony Landmarks ◽  
Room Time ◽  
Operating Room Time

Object The authors assessed the feasibility, anatomical accuracy, and cost effectiveness of frameless electromagnetic (EM) neuronavigation in conjunction with portable intraoperative CT (iCT) registration for transsphenoidal adenomectomy (TSA). Methods A prospective database was established for data obtained in 208 consecutive patients who underwent TSA in which the iCT/EM navigation technique was used. Data were compared with those acquired in a retrospective cohort of 65 consecutive patients in whom fluoroscope-assisted TSA had been performed by the same surgeon. All patients in both groups underwent transnasal removal of pituitary adenomas or neuroepithelial cysts, using identical surgical techniques with an operating microscope. In the iCT/EM technique–treated cases, a portable iCT scan was obtained immediately prior to surgery for registration to the EM navigation system, which did not require rigid head fixation. Preexisting (nonnavigation protocol) MR imaging studies were fused with the iCT scans to enable 3D navigation based on MR imaging data. The accuracy of the navigation system was determined in the first 50 iCT/EM cases by visual concordance of the navigation probe location to 5 preselected bony landmarks. For all patients in both cohorts, total operating room time, incision-to-closure time, and relative costs of imaging and surgical procedures were determined from hospital records. Results In every case, iCT registration was successful and preoperative MR images were fused to iCT scans without affecting navigation accuracy. There was 100% concordance between probe tip location and predetermined bony loci in the first 50 cases involving the iCT/EM technique. Total operating room time was significantly less in the iCT/EM cases (mean 108.9 ± 24.3 minutes [208 patients]) compared with the fluoroscopy group (mean 121.1 ± 30.7 minutes [65 patients]; p < 0.001). Similarly, incision-to-closure time was significantly less for the iCT/EM cases (mean 61.3 ± 18.2 minutes) than for the fluoroscopy cases (mean 71.75 ± 19.0 minutes; p < 0.001). Relative overall costs for iCT/EM technique and intraoperative C-arm fluoroscopy were comparable; increased costs for navigation equipment were offset by savings in operating room costs for shorter procedures. Conclusions The use of iCT/MR imaging–guided neuronavigation for transsphenoidal surgery is a time-effective, cost-efficient, safe, and technically beneficial technique.

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