Optimal Duration of Urinary Catheterization After Right-Sided Colectomy
Optimal Duration of Urinary Catheterization After Right-Sided Colectomy: Prospective, Randomized, Non-inferiority Trial
The goal of this prospective, randomized trial is to determine the optimal duration of urinary catheterization in patients that receive elective, right-sided colectomy. The main objectives of this study are:
- To compare rates of urinary retention in patients with post operative urinary catheter duration of 0 days and 1 day following right-sided colectomy.
- To compare rates of urinary tract infection (UTI) in patients with postoperative urinary catheter duration of 0 days and 1 day following right-sided colectomy.
Enrolled participants will be randomized to one of two groups, immediate removal of urinary catheter at the conclusion of the operation or removal of urinary catheter on post operative day one.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
Urinary catheterization is indicated for various operations conducted by colorectal surgeons. This process allows a tube to be inserted into the bladder to provide decompression while the patient is anesthetized. Prolonged urinary catheter placement is associated with urinary retention, urinary tract infections, and increased hospital length of stay. Clinical guidelines recommend urinary catheter discontinuation within 24 hours of operation but there is mixed evidence to support this recommendation. Further, there is a paucity of data that investigates optimal urinary catheter duration in specific colorectal surgery operations.
This prospective, randomized clinical trial aims to identify the optimal urinary catheter duration for patients undergoing elective, right-sided colectomy. Patients will be randomized into two groups: 1) urinary catheter discontinuation at the completion of surgery, or 2) urinary catheter discontinuation on post operative day 1. The primary objective is to compare rates of urinary retention between groups. The investigators hypothesize that patients with immediate urinary catheter discontinuation will have reduced rates of urinary retention and urinary tract infections compared to the group with urinary catheters maintained until post operative day 1.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前：Sacha Broccard, MD
- 電話番号：201-675-8256
- メール：Sacha.Broccard@med.usc.edu
研究場所
-
-
California
-
Los Angeles、California、アメリカ、90033
- Keck Medical Center of USC
-
コンタクト：
- Annabah Glasser, MD
- 電話番号：201-675-3256
- メール：Annabah.Glasser@med.usc.edu
-
Los Angeles、California、アメリカ、90033
- Los Angeles General Medical Center
-
コンタクト：
- Annabah Glasser, MD
- 電話番号：201-675-8256
- メール：Annabah.Glasser@med.usc.edu
-
-
参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Age 18 years or older.
- Scheduled for elective ileocecectomy, right hemicolectomy, or extended right hemicolectomy using an open, laparoscopic, or robotic approach.
- American Society of Anesthesiologists physical status class I-III.
- Ability and willingness to provide written informed consent.
Exclusion Criteria:
- History of urinary tract malignancy.
- Emergent or urgent surgery.
- Right hemicolectomy performed with another major surgical procedure on the same day.
- Genitourinary tract injury during surgery that precludes participation.
- History of urinary retention following a previous procedure, surgery, or urinary catheter removal.
- History of urinary retention that is not being actively treated.
- Neurogenic bladder.
- Chronic indwelling Foley catheter or suprapubic catheter.
- History of cystectomy or a surgically created urinary conduit, including a neobladder or ileal conduit.
- Chronic kidney disease greater than stage 2.
- History of chronic urinary tract infection.
- Current extravesicular or enterourethral fistula.
- Perioperative epidural catheter placement.
- Incarceration.
- Inability or unwillingness to provide informed consent.
- Pregnancy.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：支持療法
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的：Immediate Catheter Removal
Participants will undergo urinary catheter removal immediately after completion of surgery, in the operating room on post operative day 0. |
Removal of the urinary catheter immediately after elective right hemicolectomy before leaving the operating room.
他の名前：
|
|
アクティブコンパレータ：Postoperative Day 1 Catheter Removal
Participants will undergo urinary catheter removal on post operative day 1. |
Removal of the intra-operatively placed Foley urinary catheter on the day after elective right-sided colectomy, post-operative day one.
他の名前：
|
この研究は何を測定していますか？
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Percentage of Participants With Post Operative Urinary Retention
時間枠：From initial post operative urinary catheter removal through hospital discharge, assessed up to 90 days.
|
Post operative urinary retention will be identified by inability to void within 8 hours after catheter removal, associated suprapubic fullness and/or tenderness, and a bladder scan volume greater than 300 mL; or by spontaneous voiding with urinary symptoms and a post-void residual volume greater than 300 mL. Symptoms include suprapubic pain or fullness, bladder pressure, incomplete emptying, or straining. |
From initial post operative urinary catheter removal through hospital discharge, assessed up to 90 days.
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Percentage of Participants With Urinary Tract Infection
時間枠：From post operative day one through hospital discharge, assessed up to 90 days.
|
Urinary tract infection will be identified by clinical signs or symptoms such as suprapubic pain or tenderness, dysuria, hematuria, or urinary frequency, together with a urine culture showing more than 100,000 colony-forming units/mL of bacteria. Urinalysis and urine culture will be obtained only when infection is clinically suspected. |
From post operative day one through hospital discharge, assessed up to 90 days.
|
|
Postoperative Hospital Length of Stay
時間枠：From post operative day one through hospital discharge, assessed up to 90 days.
|
Number of inpatient hospital days from the day of surgery to the day of discharge. |
From post operative day one through hospital discharge, assessed up to 90 days.
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- HS-25-00655
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
Consent does not permit sharing; will revisit
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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