Analysis of the Incidence of Intraoperative Hypothermia and its Influencing Factors in Gynecological Patients Undergoing Laparoscopic Surgery

2022 ◽

Vol 2022 ◽

pp. 1-7

Author(s):

Yuan Cao ◽

Zhaozheng Ding ◽

Hongjia Qiang

Keyword(s):

Inguinal Hernia ◽

Laparoscopic Surgery ◽

Protective Factors ◽

Influencing Factors ◽

Univariate Analysis ◽

Postoperative Recurrence ◽

High Ligation ◽

Indirect Inguinal Hernia ◽

Back Wall ◽

Bilateral Lesions

This paper aims to analyze the recurrence of indirect inguinal hernia in children after laparoscopic surgery and investigate the influencing factors that may lead to recurrence so as to guide the prevention and treatment of postoperative recurrence of this kind of disease in the future. The data of 260 children with indirect inguinal hernia treated by laparoscopic surgery and followed up in our hospital from July 2019 to July 2021 were selected. A self-designed questionnaire was used to collect the basic data. The recurrence was analyzed, and the influencing factors of recurrence were analyzed by univariate analysis and multivariate analysis. Among 400 children after indirect inguinal hernia laparoscopic surgery, an occurrence was observed in 15 children, and the recurrence rate was 5.77%. Univariate analysis showed that the age and course of disease were not correlated with recurrence after indirect inguinal hernia laparoscopic surgery ( P > 0.05 ). Being male, bilateral lesions, exact high ligation, loose hernia back wall peritoneum, deciduous ligature, incorrect ligation of the fascia of musculus obliquus externus abdominis, large inguinal hernia, circumferential wiring, and too early off-bed activity were the influencing factors of recurrence after indirect inguinal hernia laparoscopic surgery ( P < 0.05 ). Logistic multivariate regression analysis showed that being male, bilateral lesions, loose hernia back wall peritoneum, deciduous ligature, incorrect ligation of the fascia of musculus obliquus externus abdominis, large inguinal hernia, and too early off-bed activity were the influencing factors of recurrence after indirect inguinal hernia laparoscopic surgery (OR>1, P < 0.05 ). Exact high ligation and circumferential wiring were protective factors of recurrence after indirect inguinal hernia laparoscopic surgery (OR>1, P < 0.05 ). After indirect inguinal hernia laparoscopic surgery, recurrences were affected by many factors, such as gender, site of pathological changes, and loose hernia back wall peritoneum. For these children with risk factors, reasonable intervention should be taken to reduce recurrence; exact high ligation and circumferential wiring are the protective factors. If permitted, the children meeting related indications can be treated by high ligation or circumferential wiring to reduce the risk of recurrence after indirect inguinal hernia laparoscopic surgery.

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New Concept Air Conditioning System for the Operating Room to Minimize Patient Cooling and Surgeon Heating: A Historical Control Cohort Study

World Journal of Surgery ◽

10.1007/s00268-019-05203-8 ◽

2019 ◽

Vol 44 (1) ◽

pp. 45-52

Author(s):

Hisashi Usuki ◽

Hiroaki Kitamura ◽

Yasuhisa Ando ◽

Hironobu Suto ◽

Eisuke Asano ◽

...

Keyword(s):

Colorectal Cancer ◽

Gastric Cancer ◽

Laparoscopic Surgery ◽

Cancer Patients ◽

Air Conditioning ◽

Air Conditioning System ◽

Intraoperative Hypothermia ◽

Gastric Cancer Patients ◽

Colorectal Cancer Patients ◽

New System

Abstract Background Intraoperative hypothermia is a common adverse event. For avoiding the complication due to hypothermia, many warming devices and methods have been used in perioperative period. It has been reported that more patients undergoing laparoscopic surgery tend to have hypothermia than with open surgery. To avoid intraoperative hypothermia, many kinds of warming tools have been used. But, it was also reported that some warming methods increased perceptions of distraction and physical demand. Methods To achieve both patients’ normothermia and surgeons’ comfort, new air conditioning (AC) system was designed with considering the characteristics of laparoscopic surgery. The temperature of the airflows to the patient and to the surgeons can be adjusted independently in this new system. The new system has two parts. One controls the temperature of the central area over the operation table. The air from this part falls on the patients. The other part is the lateral area beside the operating table; the air from this part falls on the surgeons. The subjects of this study were 160 gastric cancer patients and 316 colorectal cancer patients undergoing laparoscopic surgery. The temperature of the central flow was set 23.5 °C, and the temperature of the lateral flow was set 22 °C just after the anesthesia. The number of timepoints the patient spent in hypothermic state, defined as a temperature cooler by 0.5 °C or more than that at the starting point of surgery, was determined in each patient. Results In the results, the rate of hypothermic state in old operation rooms was 23.8% and that in new operation rooms was 2.7% in male gastric cancer patients (p < 0.01). And those were 37.1% in old operation rooms and 0.9% in new operation rooms in female gastric cancer patients (p < 0.01). The rate of hypothermic state in old operation rooms was 30.0% and that in new operation rooms was 9.5% in male colorectal cancer patients (p < 0.01). And those were 41.6% in old operation rooms and 8.9% in new operation rooms in female colorectal cancer patients (p < 0.01). The similar results were showed in the study, which subjects were limited the patients undergoing surgery in 2015 and 2016; which were the last year the old operation rooms were used and the first year the new operation rooms were used. Conclusions Thus, the usefulness of the new air conditioning system for achieving both patients’ normothermia and comfort of surgeons could be verified in this study.

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Risk factors for inadvertent intraoperative hypothermia in patients undergoing laparoscopic surgery: A prospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0257816 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257816

Author(s):

Huai-Ying Chen ◽

Li-Jing Su ◽

Hang-Zhou Wu ◽

Hong Zou ◽

Rong Yang ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Laparoscopic Surgery ◽

Body Temperature ◽

Abdominal Surgery ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Intraoperative Hypothermia ◽

Duration Of Surgery

Background Inadvertent intraoperative hypothermia is frequent during open surgeries; however, few studies on hypothermia during laparoscopic abdominal surgery have been reported. We aimed to investigate the incidence and risk factors for hypothermia in patients undergoing laparoscopic abdominal surgery. Methods This single-center prospective cohort observational study involved patients undergoing laparoscopic surgery between October 2018 and June 2019. Data on core body temperature and potential variables were collected. A multivariate logistic regression analysis was performed to identify the risk factors associated with hypothermia. A Cox regression analysis was used to verify the sensitivity of the results. Results In total, 690 patients were included in the analysis, of whom 200 (29.0%, 95% CI: 26%−32%) had a core temperature < 36°C. The core temperature decreased over time, and the incident hypothermia increased gradually. In the multivariate logistic regression analysis, age (OR = 1.017, 95% CI: 1.000–1.034, P = 0.050), BMI (OR = 0.938, 95% CI: 0.880–1.000; P = 0.049), baseline body temperature (OR = 0.025, 95% CI: 0.010–0.060; P < 0.001), volume of irrigation fluids (OR = 1.001, 95% CI: 1.000–1.001, P = 0.001), volume of urine (OR = 1.001, 95% CI: 1.000–1.003, P = 0.070), and duration of surgery (OR = 1.010, 95% CI: 1.006–1.015, P < 0.001) were significantly associated with hypothermia. In the Cox analysis, variables in the final model were age, BMI, baseline body temperature, volume of irrigation fluids, blood loss, and duration of surgery. Conclusions Inadvertent intraoperative hypothermia is evident in patients undergoing laparoscopic surgeries. Age, BMI, baseline body temperature, volume of irrigation fluids, and duration of surgery are significantly associated with intraoperative hypothermia.

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