title: Perioperative core body temperatures effect on outcome after colorectal resections.
abstract: The World Health Organization has set a standard of maintaining a core body temperature above 36°C in the perioperative period. The purpose of this study was to examine the relationship between both intraoperative temperature (IOT) and immediate postop core body temperature as it relates to postop complications. A retrospective analysis of a prospective database of patients who underwent an elective segmental colectomy without a stoma, for 3 diagnoses was performed. Six postoperative outcomes were examined: length of stay (LOS), placement of a nasogastric tube, return to the operating room, placement of an interventional drain, diagnosed leak, and surgical site infection (SSI). Statistics were calculated using a two-sample Wilcoxon rank-sum (Mann-Whitney) test. Seventy-nine patients met the inclusion criteria and there were no preoperative differences between the groups (those with a postop complication vs without). LOS > 9 days (36.64°C vs 35.98°C; P = 0.011) and clinical leak (37.06°C vs 35.99°C; P = 0.005) both had a statistically higher average IOT than those who did not. Patients with SSI trended to a higher IOT (36.44°C vs 35.99°C; P = 0.062). When the last IOT recorded was compared with the six outcomes, again length of stay and leak both were statistically significant (P = 0.018, P = 0.012) showing a higher temperature related to a higher complication rate. No other complications were related to IOT, nor did postop temperature relate to complication. In our data, relatively lower IOTs were protective for LOS and clinical leaks, with a trend of lower SSI rates. Further research is needed to fully endorse or refute the absolute recommendations for core body temperature.
authors.affiliation: Department of Colon and Rectal Surgery, Vanderbilt University, Nashville, Tennessee 37232, USA. Timothy.geiger@vanderbilt.edu
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Geiger
authors.forename: Sara
authors.initials: S
authors.lastname: Horst
authors.forename: Roberta
authors.initials: R
authors.lastname: Muldoon
authors.forename: Paul E
authors.initials: PE
authors.lastname: Wise
authors.forename: Jesse
authors.initials: J
authors.lastname: Enrenfeld
authors.forename: Ben
authors.initials: B
authors.lastname: Poulose
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Herline
mesh_terms: D000328:Adult; D000368:Aged; D001831:Body Temperature / Q000502:physiology*; D003082:Colectomy / Q000379:methods*; D003108:Colonic Diseases / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D012002:Rectal Diseases / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult