• Sung Jin Lee, Woo Jin Hyung, Bon Nyeo Koo, Ji Yeon Lee, Na Hyung Jun, Sun Chung Kim, Jung Won Kim, Jia Liu, and Ki Jun Kim.
• Department of Anesthesiology, Pain Medicine and Anesthesia, Pain Research Institute, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, C.P.O. Box 8044, Seoul, 120-752, Korea.
• Surg Endosc. 2008 Mar 1; 22 (3): 724-30.

BackgroundRecently, the laparoscopic surgical technique has been widely applied to major surgery as it can minimize surgical incision, reduce blood loss, and shorten hospital stay. In this study, we evaluated the effectiveness of the laparoscopic surgery on postoperative micturitional function in comparison to open surgery.MethodSixty patients undergoing subtotal gastrectomy were assigned to either laparoscopic (L group, n = 30) or open surgery (O group, n = 30) groups. The combined thoracic epidural-general anesthesia was performed on all patients, and epidural patient-controlled analgesia (PCA) using ropivacaine and sufentanil was maintained for two days following surgery. After surgery, visual analog pain score (VAS), levels of sensory and motor block, observer's assessment of alertness/sedation score (OAA/S), time to first flatus, ambulation and oral intake, and micturition function were assessed.ResultsThe L group showed much earlier ambulation, flatus and oral intake than the O group. Although the scores of VAS and OAA/S were not significantly different between the two groups, the micturition problem scores of the L group were lower than that of the O group (P < 0.05). All patients of the L group had no difficulty in self-voiding, whereas four patients in the O group required urinary catheterization on the first postoperative day (POD1).ConclusionsPatients who underwent laparoscopic subtotal gastrectomy had a low incidence of micturitional problem and showed early recovery. Therefore, urinary catheterization on POD1 may not be a routine procedure for those who undergo laparoscopic subtotal gastrectomy under combined thoracic epidural-general anesthesia.

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