Obesity surgery · 2025
Association Between Sugammadex Use and Risk of Postoperative Urinary Complications after Metabolic and Bariatric Surgery: A Multi-Institutional Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Ko Ching-Chung, Chang Li-Chen, Hung Kuo-Chuan, Lai Yi-Chen, Wu Jheng-Yan, Kang Fu-Chi
Аннотация
BACKGROUND: Postoperative urinary retention (POUR) is a common complication of metabolic and bariatric surgery (MBS) and is potentially exacerbated by neostigmine reversal and its required anticholinergic agents. This multi-institutional study aimed to evaluate the association between sugammadex use and postoperative urinary tract complications in this surgical population.
METHODS: This retrospective cohort study analyzed TriNetX Research Network data from adult patients undergoing laparoscopic MBS (2015-2024). Patients receiving sugammadex were compared with those receiving neostigmine with glycopyrrolate/atropine using propensity score matching. Outcomes of interest included risks of POUR (primary outcome), urinary tract infection, cystitis, and Foley catheter insertion within 30 days postoperatively.
RESULTS: After propensity score matching, 31,692 patients were analyzed. At the 30-day follow-up, sugammadex use was associated with a lower risk of POUR (odds ratio [OR] 0.20, 95% confidence interval [CI] 0.15-0.26, p < 0.001) and Foley catheter insertion (OR 0.38, 95% CI 0.26-0.55, p < 0.001), without differences in other outcomes. Temporal analysis showed that sugammadex conferred the greatest protection against POUR (OR 0.19, p < 0.001) and catheter insertion (OR 0.36, p < 0.001) during the early postoperative period (0-7 days), with no significant differences observed in other outcomes. In the late period (8-30 days), sugammadex use was associated with a delayed reduction in urinary tract infections (OR 0.67, 95% CI 0.48-0.94, p = 0.019), without differences in other outcomes.
CONCLUSION: Sugammadex use is associated with significantly reduced postoperative urinary complications following MBS, offering important clinical advantages over traditional neuromuscular blockade reversal.
METHODS: This retrospective cohort study analyzed TriNetX Research Network data from adult patients undergoing laparoscopic MBS (2015-2024). Patients receiving sugammadex were compared with those receiving neostigmine with glycopyrrolate/atropine using propensity score matching. Outcomes of interest included risks of POUR (primary outcome), urinary tract infection, cystitis, and Foley catheter insertion within 30 days postoperatively.
RESULTS: After propensity score matching, 31,692 patients were analyzed. At the 30-day follow-up, sugammadex use was associated with a lower risk of POUR (odds ratio [OR] 0.20, 95% confidence interval [CI] 0.15-0.26, p < 0.001) and Foley catheter insertion (OR 0.38, 95% CI 0.26-0.55, p < 0.001), without differences in other outcomes. Temporal analysis showed that sugammadex conferred the greatest protection against POUR (OR 0.19, p < 0.001) and catheter insertion (OR 0.36, p < 0.001) during the early postoperative period (0-7 days), with no significant differences observed in other outcomes. In the late period (8-30 days), sugammadex use was associated with a delayed reduction in urinary tract infections (OR 0.67, 95% CI 0.48-0.94, p = 0.019), without differences in other outcomes.
CONCLUSION: Sugammadex use is associated with significantly reduced postoperative urinary complications following MBS, offering important clinical advantages over traditional neuromuscular blockade reversal.