Our Summary

This research paper looks at how urinary tract infections (UTIs) can affect patients who have undergone specific types of colorectal surgeries (right colectomy and abdominal perineal resection). The researchers used data from 2006 to 2012 and analyzed the timing of UTI diagnosis, whether it was during the hospital stay or after discharge, and any related complications.

The findings showed that out of 7,615 colorectal surgeries, 1.4% resulted in UTIs. In another type of surgery (abdominal perineal resections), 3.5% of the 2,493 surgeries resulted in UTIs.

The study found that UTIs were associated with an extended hospital stay for both types of surgeries (59.0% longer for right colectomy and 37.4% longer for abdominal perineal resection). However, UTIs did not increase the risk of death.

Interestingly, patients who were diagnosed with a UTI after being discharged from the hospital were significantly more likely to be readmitted (37.7% vs. 9.7%). Therefore, if a patient gets a UTI after leaving the hospital, they have a high chance of having to go back to the hospital.

In conclusion, getting a UTI after colorectal surgery can lead to a longer hospital stay but does not increase the risk of death. However, if the UTI occurs after the patient is discharged, there is a high chance they will need to be readmitted to the hospital.

FAQs

  1. What is the impact of urinary tract infection (UTI) on the length of stay, re-admission, and death rate in colorectal surgical patients?
  2. What is the correlation between the timing of UTI diagnosis and re-admission rates in colorectal surgical patients?
  3. How does UTI affect patients who have undergone right colectomy and abdominal perineal resection procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about colectomy is to be vigilant about monitoring for signs of infection, such as urinary tract infections (UTIs), both during their hospital stay and after discharge. Promptly reporting any symptoms of a UTI, such as burning with urination or frequent urination, to their healthcare provider can help prevent complications and reduce the risk of re-admission to the hospital. Additionally, following post-operative care instructions, including proper wound care and taking prescribed antibiotics, can help promote a successful recovery after colectomy.

Suitable For

Patients who are typically recommended for colectomy include those with colorectal cancer, inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), diverticulitis, familial adenomatous polyposis, or other conditions that affect the colon. Additionally, patients who have not responded to other treatments such as medications or lifestyle changes may also be recommended for colectomy.

Timeline

Before colectomy:

  • Patient undergoes pre-operative assessments, including blood tests, imaging studies, and consultations with healthcare providers.
  • Patient may need to follow a special diet and bowel preparation regimen before surgery.
  • Patient may have a pre-operative consultation with a stoma nurse if a colostomy or ileostomy is planned.
  • Patient may attend pre-operative education sessions to learn about the surgery and post-operative care.

After colectomy:

  • Patient is closely monitored in the post-anesthesia care unit (PACU) for recovery from surgery.
  • Patient may have a nasogastric tube in place to decompress the stomach.
  • Patient is gradually advanced to a clear liquid diet and then to solid foods as tolerated.
  • Patient may need pain medication to manage post-operative discomfort.
  • Patient may have drains and/or a urinary catheter in place to drain fluids from the surgical site.
  • Patient begins physical therapy and gradual mobilization to prevent complications such as blood clots and pneumonia.
  • Patient may need to learn how to care for a stoma if a colostomy or ileostomy was created during surgery.
  • Patient is discharged from the hospital once they are medically stable and able to manage at home.
  • Patient follows up with healthcare providers for wound care, stoma care, and monitoring of recovery progress.

What to Ask Your Doctor

  1. What is the risk of developing a urinary tract infection (UTI) after colectomy surgery?
  2. How is a UTI diagnosed and treated after surgery?
  3. How can I prevent UTIs during the recovery period?
  4. What are the potential complications associated with UTIs after colectomy surgery?
  5. How will a UTI affect my length of stay in the hospital?
  6. What should I do if I suspect I have a UTI after returning home from the hospital?
  7. Are there any specific signs or symptoms of a UTI that I should be aware of?
  8. Will I need to take any medications or follow-up care to prevent UTIs in the future?
  9. How will a UTI impact my overall recovery and healing process after colectomy surgery?
  10. Are there any lifestyle changes or precautions I should take to reduce my risk of developing a UTI after surgery?

Reference

Authors: Armstrong JG, Li CH, Liao J, Byrn JC. Journal: Surg Infect (Larchmt). 2017 Jul;18(5):570-576. doi: 10.1089/sur.2016.282. Epub 2017 Mar 7. PMID: 28266900