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Perioperative Core Body Temperatures Effect on Outcome after Colorectal Resections

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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.
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Document Type: Research Article

Affiliations: 1: Department of Colon and Rectal Surgery, Vanderbilt University, Nashville, Tennessee, USA 2: Department of Gastroenterology, Vanderbilt University, Nashville, Tennessee, USA 3: Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee, USA 4: Department of General Surgery, Vanderbilt University, Nashville, Tennessee, USA

Publication date: May 1, 2012

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  • The Southeastern Surgical Congress owns and publishes The American Surgeon monthly. It is the official journal of the Congress and the Southern California Chapter of the American College of Surgeons, which all members receive each month. The journal brings up to date clinical advances in surgical knowledge in a popular reference format. In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. If you have a manuscript you'd like to see published in The American Surgeon select "Information for Authors" from the Related Information options below. A Copyright Release Form must accompany all manuscripts submitted.
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