Risk factors for perioperative complications in endoscopic surgery with irrigation.
OBJECTIVE
Currently, endoscopic medicine is being increasingly used, albeit not without risks. Therefore, this study evaluated the factors associated with perioperative complications in endoscopic surgery with intraoperative irrigation.


METHODS
A cohort study of six months duration. Patients aged ≥ 18 years undergoing endoscopic surgery with the use of irrigation fluids during the intraoperative period were included. Exclusion criteria were: use of diuretics, kidney failure, cognitive impairment, hyponatremia prior to surgery, pregnancy, and critically ill. The patients who presented with or without complications during the perioperative period were allocated into two groups. Complications evaluated were related to neurological, cardiovascular and renal changes, and perioperative bleeding.


RESULTS
In total, 181 patients were enrolled and 39 excluded; therefore, 142 patients met the study criteria. Patients with complications amounted to 21.8%, with higher prevalence in endoscopic prostate surgery, followed by hysteroscopy, bladder, knee, and shoulder arthroscopy (58.1%, 36.9%, 19.4%, 3.8%, 3.2% respectively). When comparing both groups, we found association with complications in univariate analysis: age, sex, smoking, heart disease, ASA, serum sodium at the end of surgery, total irrigation fluid administered, TURP, and hysteroscopy. However, in multiple regression analysis for complications, only age (OR = 1.048), serum sodium (OR = 0.962), and volume of irrigation fluid administered during surgery (OR = 1.001) were independent variables.
Hospital do Servidor Publico Estadual, Faculdade de Medicina da Universidade de Sao Paulo, Brazil. joao.s@globo.com
João Manoel
JM
Silva
Maria Alice
MA
Barros
Milena Aur L
MA
Chahda
Igor Martins
IM
Santos
Lauro Yoiti
LY
Marubayashi
Luiz Marcelo Sá
LM
Malbouisson
D000368:Aged; D015331:Cohort Studies; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D007507:Therapeutic Irrigation / Q000009:adverse effects*