Takayama Maho, Snyder Rebecca A, Lyu Heather G, Mensah Cassius K, Prakash Laura R, Landry Jace P, Tsai Edward, Siddiqui Zuhair A, Maxwell Jessica E, Kim Michael P, Tzeng Ching-Wei D, Lee Jeffrey E, Katz Matthew H G, Ikoma Naruhiko
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ann Surg Oncol. 2025 Sep 11. doi: 10.1245/s10434-025-18286-6.
Hypothermia frequently occurs during abdominal operations and negatively impacts postoperative outcomes. However, the association of hypothermia during pancreaticoduodenectomy (PD) with postoperative pancreatic fistula (POPF) remains unclear.
This retrospective study analyzed data from patients who underwent open PD at our institution from January 2018 through March 2024. Data on patient demographics, tumor characteristics, surgical outcomes (including POPF), and intraoperative temperature were collected. We sought to determine the incidence of intraoperative hypothermia, defined as an intraoperative core temperature below 36.0 °C, and investigated its association with POPF using multivariable logistic regression models.
Among 374 patients, 293 (78.3%) experienced hypothermia and 36 (9.6%) developed clinically relevant POPF. Multivariable analysis revealed that age ≥ 55 years (odds ratio [OR] 2.2; 95% confidence interval [CI] 1.2-4.0; p = 0.012) and operative time ≥ 435 min (OR 2.5; 95% CI 1.4-4.2; p = 0.001) were associated with increased incidence of hypothermia, while body mass index ≥ 25 kg/m was protective (OR 0.4; 95% CI 0.2-0.6; p < 0.001). Factors associated with POPF included body mass index ≥ 25 kg/m (OR 3.2; 95% CI 1.1-9.0; p = 0.031), nonpancreatic ductal adenocarcinoma histology (OR 10.3; 95% CI 3.8-27.8; p < 0.001), recent PD (from November 2020 to March 2024; OR 0.4; 95% CI 0.1-1.0; p = 0.045), and hypothermia (OR 3.4; 95% CI 1.0-11.3; p = 0.044).
Among patients undergoing open PD, hypothermia is common and is associated with increased risk for POPF. Further studies are needed to establish a validated and standardized definition of intraoperative hypothermia and to examine any associations with procedure-specific postoperative complications.
腹部手术期间经常发生体温过低，对术后结局产生负面影响。然而，胰十二指肠切除术（PD）期间体温过低与术后胰瘘（POPF）之间的关联仍不清楚。
这项回顾性研究分析了2018年1月至2024年3月在本机构接受开放性PD手术的患者的数据。收集了患者人口统计学、肿瘤特征、手术结局（包括POPF）和术中体温的数据。我们试图确定术中体温过低的发生率（定义为术中核心体温低于36.0°C），并使用多变量逻辑回归模型研究其与POPF的关联。
在374例患者中，293例（78.3%）出现体温过低，36例（9.6%）发生临床相关的POPF。多变量分析显示，年龄≥55岁（比值比[OR]2.2；95%置信区间[CI]1.2 - 4.0；p = 0.012）和手术时间≥435分钟（OR 2.5；95% CI 1.4 - 4.2；p = 0.001）与体温过低发生率增加相关，而体重指数≥25 kg/m²具有保护作用（OR 0.4；95% CI 0.2 - 0.6；p < 0.001）。与POPF相关的因素包括体重指数≥25 kg/m²（OR 3.2；95% CI 1.1 - 9.0；p = 0.031）、非胰腺导管腺癌组织学类型（OR 10.3；95% CI 3.8 - 27.8；p < 0.001）、近期PD手术（2020年11月至2024年3月；OR 0.4；95% CI 0.1 - 1.0；p = 0.045）和体温过低（OR 3.4；95% CI 1.0 - 11.3；p = 0.044）。
在接受开放性PD手术的患者中，体温过低很常见，并且与POPF风险增加相关。需要进一步研究以建立经过验证的术中体温过低标准化定义，并检查其与特定手术相关术后并发症的任何关联。
