Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL, USA.
Division of General and Thoracic Surgery, The Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, ON, Canada.
Pediatr Surg Int. 2024 Aug 19;40(1):235. doi: 10.1007/s00383-024-05823-9.
Early post-operative fever (< 48 h) is common in adults and children and seldom indicative of an infection. Guidance to limit excessive evaluation in adults is well-characterized but similar studies for the pediatric population is scarce. This study was performed to better clarify which infants should undergo investigation for post-operative fever after colorectal reconstructive surgical procedures.
We performed a retrospective chart review of all infants under one year of age who underwent elective reconstruction for anorectal malformations (ARM) and Hirschsprung Disease (HD) between June 2018 and April 2020 at a single institution. Patient and perioperative characteristics were analyzed to evaluate for possible factors associated with infection.
Sixty-eight infants met study criteria - 38 (55.9%) had HD and 30 (44.1%) had ARM. Twenty-two infants (32.4%) had early post-operative fever. A definitive infectious cause was identified in only two infants. The presence of a colostomy pre-operatively and longer operative times were associated with increased risk of post-operative fever (62.5% vs. 22.7% and 175 min vs. 150 min respectively, p < 0.05).
Early post-operative fever in infants after colorectal surgery is common and rarely associated with an infection. Further research is needed to determine which infants require further work-up and which can be safely observed.
成人和儿童术后早期发热（<48 小时）很常见，很少表明存在感染。限制成人过度评估的指导已得到充分描述，但针对儿科人群的类似研究却很少。本研究旨在更好地阐明哪些婴儿在接受结直肠重建手术后应进行发热的检查。
我们对 2018 年 6 月至 2020 年 4 月期间在一家机构接受择期肛门直肠畸形（ARM）和先天性巨结肠（HD）重建手术的所有一岁以下婴儿进行了回顾性图表审查。分析患者和围手术期特征，以评估与感染相关的可能因素。
68 名婴儿符合研究标准-38 名（55.9%）患有 HD，30 名（44.1%）患有 ARM。22 名婴儿（32.4%）术后早期发热。仅在两名婴儿中确定了明确的感染原因。术前存在结肠造口术和较长的手术时间与术后发热的风险增加相关（分别为 62.5%比 22.7%和 175 分钟比 150 分钟，p<0.05）。
结直肠手术后婴儿的早期术后发热很常见，很少与感染有关。需要进一步研究以确定哪些婴儿需要进一步检查，哪些可以安全观察。
