Laparoscopic Liver Lobectomy
Conditions
Brief summary
The primary aim was to assess the impact of early catheter removal on postoperative urinary function, urinary complications, and recovery milestones.
Interventions
PROCEDUREstructured multidisciplinary Enhanced Recovery
Participants received a structured multidisciplinary Enhanced Recovery After Surgery (ERAS) program. Key interventions: preoperative education with an ERAS diary, shortened fasting with oral carbohydrate loading, opioid-sparing multimodal anesthesia, normothermia maintenance, and no routine abdominal drainage. Postoperatively, the urinary catheter was removed within 6 hours, with early oral hydration beginning 2 hours postoperatively, assisted ambulation within 6 hours, multimodal analgesia, and restrictive fluid management.
PROCEDUREconventional perioperative care established by the Hepatobiliary Surgery Department
Participants received conventional perioperative care established by the Hepatobiliary Surgery Department, including routine preoperative fasting (≥8 h for solids, ≥6 h for fluids) without carbohydrate loading, standard balanced general anesthesia, routine abdominal drainage, opioid-based analgesia as needed, fasting for 6 hours postoperatively, oral intake initiated on postoperative day (POD) 1, and urinary catheter removal at approximately 24 hours postoperatively (POD 1).
Sponsors
Yu Zhang
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Age 18 to 75 years. 2. Preoperative diagnosis of benign or malignant liver tumors, with a plan for standard laparoscopic liver lobectomy. 3. Liver function classified as Child-Pugh grade A. 4. Indocyanine green (ICG) 15-minute retention rate (ICG R15) \< 14%. 5. American Society of Anesthesiologists (ASA) physical status classification I-III. 6. Normal preoperative urinary function (residual urine volume \< 50 mL). 7. Provision of written informed consent.
Exclusion criteria
1. Emergency surgery or conversion to an open surgical procedure. 2. Concurrent neurogenic bladder or chronic urinary tract infection. 3. Planned transfer to the intensive care unit (ICU) following surgery. 4. Anticipated intraoperative blood loss exceeding 1000 mL. 5. Presence of urethral stricture or complications related to intraoperative catheterization. 6. Unwillingness to participate in the trial.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Duration of urinary catheter indwelling (hours) | 7 days |
Countries
China
Outcome results
None listed