Urologia internationalis · 2023
Risk Factors for Intraoperative Hypothermia during Holmium Laser Enucleation of the Prostate.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Morishige Sae, Ohyama Takehiro, Fujita Nobuko, Kameda Megumi, Yonekura Yuuki, Endo Fumiyasu, Abe Seiki
Аннотация
INTRODUCTION: Holmium laser enucleation of the prostate (HoLEP) is considered a size-independent gold standard for benign prostatic hyperplasia (BPH), and there is no upper limit of prostate weight that can be treated. Tissue retrieval can be time-consuming in cases of significant prostatic enlargement, which may lead to intraoperative hypothermia. As there are few studies on perioperative hypothermia in HoLEP, we conducted a retrospective study of patients who underwent HoLEP at our hospital.
METHODS: The data of 147 patients who underwent HoLEP at our hospital were retrospectively collected and analyzed for the occurrence of intraoperative hypothermia (temperature <36°C); age, body mass index (BMI), anesthesia method, body temperature, total fluid infusion, operation time, and irrigation fluid were the explanatory variables.
RESULTS: Intraoperative hypothermia was observed in 46 of 147 patients (31.3%). Simple logistic regression analysis showed that age (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.01-1.13, p = 0.021), BMI (OR: 0.84, 95% CI: 0.72-0.96, p = 0.017), spinal anesthesia (OR: 4.92, 95% CI: 1.86-14.99, p = 0.002), and surgical time (OR: 1.04, 95% CI: 1.01-1.06, p = 0.006) were predictors of hypothermia. The decrease in body temperature was more pronounced with longer-duration surgery and reached 0.58°C at 180 min.
CONCLUSION: General anesthesia, instead of spinal anesthesia, is recommended in high-risk patients with advanced age or low BMI to avoid intraoperative hypothermia during HoLEP. Two-stage morcellation may be considered for large adenomas, when a prolonged operative time and hypothermia are anticipated.
METHODS: The data of 147 patients who underwent HoLEP at our hospital were retrospectively collected and analyzed for the occurrence of intraoperative hypothermia (temperature <36°C); age, body mass index (BMI), anesthesia method, body temperature, total fluid infusion, operation time, and irrigation fluid were the explanatory variables.
RESULTS: Intraoperative hypothermia was observed in 46 of 147 patients (31.3%). Simple logistic regression analysis showed that age (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.01-1.13, p = 0.021), BMI (OR: 0.84, 95% CI: 0.72-0.96, p = 0.017), spinal anesthesia (OR: 4.92, 95% CI: 1.86-14.99, p = 0.002), and surgical time (OR: 1.04, 95% CI: 1.01-1.06, p = 0.006) were predictors of hypothermia. The decrease in body temperature was more pronounced with longer-duration surgery and reached 0.58°C at 180 min.
CONCLUSION: General anesthesia, instead of spinal anesthesia, is recommended in high-risk patients with advanced age or low BMI to avoid intraoperative hypothermia during HoLEP. Two-stage morcellation may be considered for large adenomas, when a prolonged operative time and hypothermia are anticipated.