title: Risk factors for perioperative complications in endoscopic surgery with irrigation.
abstract: 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.
  
  
  CONCLUSIONS
  The incidence of serious complications in endoscopic surgeries is high. Serum sodium at the end of the operation, amount of irrigation fluid, and age were strong independent factors associated with the problem. Thus, these factors must be taken into account in these surgeries.
authors.affiliation: TSA; Coordinator of the Surgery Unit for Critically Ill Patients, Hospital do Servidor Público Estadual (HSPE); Co-responsible for the Center for Teaching and Training (CET)/Brazilian Society of Anesthesiology (SBA), HSPE; Science Reviewer of the Intensive Care Unit, HSPE; Master in Medical Sciences, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil. Electronic address: joao.s@globo.com.
authors.forename: João Manoel
authors.initials: JM
authors.lastname: Silva
authors.affiliation: Resident ME3, Anesthesiology Service, HSPE, São Paulo, Brazil.
authors.forename: Maria Alice
authors.initials: MA
authors.lastname: Barros
authors.affiliation: Resident ME3, Anesthesiology Service, HSPE, São Paulo, Brazil.
authors.forename: Milena Aur L
authors.initials: MA
authors.lastname: Chahda
authors.affiliation: Resident ME3, Anesthesiology Service, HSPE, São Paulo, Brazil.
authors.forename: Igor Martins
authors.initials: IM
authors.lastname: Santos
authors.affiliation: Anesthesiologist; Director of the Anesthesiology Service, Perioperative Medicine, Intensive Pain and Therapy, S/S Ltda - SAMMEDI, São Paulo, Brazil.
authors.forename: Lauro Yoiti
authors.initials: LY
authors.lastname: Marubayashi
authors.affiliation: TSA; Coordinator of the Surgical ICU Anesthesia Division of Hospital das Clinicas, FMUSP; Coordinator of the Surgery Unit for Critically Ill Patients, HSPE; PhD in Medical Sciences, FMUSP, São Paulo, Brazil.
authors.forename: Luiz Marcelo Sá
authors.initials: LM
authors.lastname: Malbouisson
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D012044:Regression Analysis; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D007507:Therapeutic Irrigation / Q000009:adverse effects*
chemical_list: D012964:Sodium
keywords: Anesthesia; Endoscopy; Hyponatremia; Postoperative Complications; Risk Assessment; Risk Factors.