Cost-effectiveness Analysis of Perioperative No Indwelling Urinary Catheter in Lung Cancer Patients with Pulmonary Lobectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding?author：

Keywords：

Indwelling urinary catheter; Cost-effectiveness; Lung cancer surgery

DOI：

10.7507/1007-4848.20160100

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Objective To investigate cost-effectiveness of no indwelling urinary catheter in pulmonary lobectomy patients and to confirm the advances of no indwelling urinary catheter. Methods We recruited 148 lung cancer patients who were scheduled for pulmonary lobectomy under general anesthesia in West China Hospital from July through December 2015. These patients were divided into two groups including an indwelling urinary catheter group (74 patients, 45 males and 29 females, at age of 52.55±19.87 years) and a no indwelling urinary catheter group (74 patients, 42 males and 32 females, at age of 54.03±16.66 years). Indexes of cost-effectiveness of the two groups were compared. Results There was no statistical difference between the two groups in duration of indwelling catheter (1.56±0.0.65 d versus 1.68±0.91 d, P=0.077). Material expense(4 811.48 yuan versus 296.74 yuan, P=0.045), cost of nursing care (7 413.32 yuan versus 457.32 yuan, P=0.013), and total expense (12 224.8 yuan versus 754.06 yuan, P=0.000) in the indwelling catheter group were higher than those in the no indwelling catheter group. Material expense per patient (65.02±5.62 yuan/patient-time versus 4.01±0.00 yuan/patient-time, P=0.000), cost of nursing care per patient (100.18±7.19 yuan/patient-time versus 6.18±1.22 yuan/patient-time, P=0.000), and total cost per patient (165.20±12.81 yuan/patienttime versus 10.19±1.22 yuan/patient-time, P=0.000) in the indwelling catheter group were higher than those in the no indwelling catheter group. Conclusion Both costs and labor of nurse can be cut down for appropriate lung cancer patients undergoing lobectomy without routine indwelling urinary catheter.

Citation： YANGMei, CHENJuan, CHEGuo-wei, QIUFang, WANGWei, LINLin, LIULun-xu. Cost-effectiveness Analysis of Perioperative No Indwelling Urinary Catheter in Lung Cancer Patients with Pulmonary Lobectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(5): 421-424. doi: 10.7507/1007-4848.20160100 Copy

1.	?車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.
2.	車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
3.	Shah RD, D'Amico TA. Modern impact of video assisted thoracic surgery. J Thorac Dis, 2014, 6(Suppl 6): S631-S636.
4.	邱舫, 楊梅, 王維, 等. 肺葉切除術后患者無尿管留置的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2015, 22(7): 634-637.
5.	徐志華, 楊梅, 邱舫, 等. 肺癌患者圍手術期無痛性留置導尿的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2016, 23(4): 323-327.
6.	Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
7.	Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
8.	韓兆杰, 宋志芳, 蘇建華, 等. 單胸腔引流管在肺癌術后快速康復中的應用. 中國胸心血管外科臨床雜志, 2014, 21(1): 17-20.
9.	楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后16F較28F胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
10.	Nanavati AJ, Prabhakar S. Fast-track surgery: Toward comprehensive peri-operative care. Anesth Essays Res, 2014, 8(2): 127-133.
11.	Yoo BE, Kye BH, Kim HJ, et al. Early removal of the urinary catheter after total or tumor-specific mesorectal excision for rectal cancer is safe. Dis Colon Rectum, 2015, 58(7): 686-691.
12.	Hollingsworth JM, Rogers MA, Krein SL, et al. Determining the noninfectious complications of indwelling urethral catheters: a systematic review and meta-analysis. Ann Intern Med, 2013, 159(6): 401-410.
13.	Greer SF, Sethi AK, Hecker MT, et al. Survey of patients' knowledge and opinions regarding the use of indwelling urinary catheters. Infect Control Hosp Epidemiol, 2011, 32(2): 174-176.
14.	Nicolle LE. Urinary catheter-associated infections. Infect Dis Clin North Am, 2012, 26(1): 13-27.
15.	Kamdar A, Yahya A, Thangaraj L. Retrospective observational study of the incidence of short-term indwelling urinary catheters in elderly patients with neck of femur fractures. Geriatr Gerontol Int, 2009, 9(2): 131-134.
16.	Kwaan MR, Lee JT, Rothenberger DA, et al. Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Dis Colon Rectum, 2015, 58(4): 401-405.
17.	Feneley RC, Hopley IB, Wells PN. Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol, 2015, 39(8): 459-470.
18.	趙金蘭, 邱姝婷, 許寧惠, 等. 尿管留置對胸科手術患者全身麻醉蘇醒期躁動影響的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2016, 23(4): 315-318.
19.	邱舫, 楊梅, 車國衛, 等. 胸腔鏡肺葉切除術患者圍手術期無尿管導致尿潴留的高危因素. 中國胸心血管外科臨床雜志, 2016, 23(4): 328-333.
20.	Sánchez Villar I. Removal of short-term indwelling urethral catheters. Nurs Stand, 2008, 22(22): 42-45.

1. ?車國衛, 李為民, 劉倫旭. 快速肺康復需要圍手術期流程優化. 中國胸心血管外科臨床雜志, 2016, 23(3): 216-220.
2. 車國衛, 劉倫旭, 石應康. 加速康復外科臨床應用現狀與思考. 中國胸心血管外科臨床雜志, 2016, 23(3): 211-215.
3. Shah RD, D'Amico TA. Modern impact of video assisted thoracic surgery. J Thorac Dis, 2014, 6(Suppl 6): S631-S636.
4. 邱舫, 楊梅, 王維, 等. 肺葉切除術后患者無尿管留置的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2015, 22(7): 634-637.
5. 徐志華, 楊梅, 邱舫, 等. 肺癌患者圍手術期無痛性留置導尿的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2016, 23(4): 323-327.
6. Liu L, Che G, Pu Q, et al. A new concept of endoscopic lung cancer resection: Single-direction thoracoscopic lobectomy. Surg Oncol, 2010, 19(2): e71-e77.
7. Zhi XY, Yu JM, Shi YK. Chinese guidelines on the diagnosis and treatment of primary lung cancer (2015 version). Cancer, 2015, 121(Suppl 17): 3165-3181.
8. 韓兆杰, 宋志芳, 蘇建華, 等. 單胸腔引流管在肺癌術后快速康復中的應用. 中國胸心血管外科臨床雜志, 2014, 21(1): 17-20.
9. 楊梅, 樊駿, 周紅霞, 等. 胸腔鏡肺癌肺葉切除術后16F較28F胸腔引流管應用的臨床優勢. 中國肺癌雜志, 2015, 18(8): 512-517.
10. Nanavati AJ, Prabhakar S. Fast-track surgery: Toward comprehensive peri-operative care. Anesth Essays Res, 2014, 8(2): 127-133.
11. Yoo BE, Kye BH, Kim HJ, et al. Early removal of the urinary catheter after total or tumor-specific mesorectal excision for rectal cancer is safe. Dis Colon Rectum, 2015, 58(7): 686-691.
12. Hollingsworth JM, Rogers MA, Krein SL, et al. Determining the noninfectious complications of indwelling urethral catheters: a systematic review and meta-analysis. Ann Intern Med, 2013, 159(6): 401-410.
13. Greer SF, Sethi AK, Hecker MT, et al. Survey of patients' knowledge and opinions regarding the use of indwelling urinary catheters. Infect Control Hosp Epidemiol, 2011, 32(2): 174-176.
14. Nicolle LE. Urinary catheter-associated infections. Infect Dis Clin North Am, 2012, 26(1): 13-27.
15. Kamdar A, Yahya A, Thangaraj L. Retrospective observational study of the incidence of short-term indwelling urinary catheters in elderly patients with neck of femur fractures. Geriatr Gerontol Int, 2009, 9(2): 131-134.
16. Kwaan MR, Lee JT, Rothenberger DA, et al. Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Dis Colon Rectum, 2015, 58(4): 401-405.
17. Feneley RC, Hopley IB, Wells PN. Urinary catheters: history, current status, adverse events and research agenda. J Med Eng Technol, 2015, 39(8): 459-470.
18. 趙金蘭, 邱姝婷, 許寧惠, 等. 尿管留置對胸科手術患者全身麻醉蘇醒期躁動影響的前瞻性隊列研究. 中國胸心血管外科臨床雜志, 2016, 23(4): 315-318.
19. 邱舫, 楊梅, 車國衛, 等. 胸腔鏡肺葉切除術患者圍手術期無尿管導致尿潴留的高危因素. 中國胸心血管外科臨床雜志, 2016, 23(4): 328-333.
20. Sánchez Villar I. Removal of short-term indwelling urethral catheters. Nurs Stand, 2008, 22(22): 42-45.

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