Fu Xiaobao,Xu Nana,Li Xiaoran,et al.Analysis of influencing factors of fever after laparoscopic pyeloplasty in children[J].Journal of Clinical Pediatric Surgery,,():457-461.[doi:10.3760/cma.j.cn101785-202405061]
Analysis of influencing factors of fever after laparoscopic pyeloplasty in children
- Keywords:
- Ureter; Renal Pelvis; Laparoscope; Fever; Root Cause Analysis; Child
- Abstract:
- Objective Toexplore the characteristics and related influencing factors of fever during hospitalization after laparoscopic pyeloplasty (LP) for congenital ureteropelvic junction obstruction (UPJO) in children to provide references for the prevention and intervention of postoperative fever in clinical practices.Methods A retrospective analysis was performed for the relevant clinical data of 143 children with congenital UPJO undergoing primary unilateral LP (with intraoperative ureteral stenting) by the same surgical team at Department of Urology,Second Hospital of Lanzhou University from June 2018 to August 2023.Duration of postoperative fever (DPF),highest postoperative body temperature (HPBT) and postoperative high fever (PHF,body temperature ≥39℃) were recorded.The correlations between such variables as gender,age,surgical sideness,operative duration,intraoperative bleeding volume,weight,postoperative urinary leakage,preoperative abnormity of urine routine (AUR),preoperative anteroposterior diameter (APD) of renal pelvis and intraoperative stent type with DPF/HPBT/PHF were examined.Results No correlation existed between DPF,HPBT,operative duration,intraoperative bleeding volume,weight or preoperative APD.And there was no significant difference in gender or surgical sideness (P>0.05).Age was correlated negatively with DPF (r=-0.307,P<0.01); DPF was significantly correlated positively with HPBT (r=0.717,P<0.01).DPF showed significant differences in stent type (P=0.003) and preoperative AUR (P<0.01).However,no significant difference existed in postoperative urinary leakage (P=0.112); HPBT showed significant differences in stent type (P=0.01),postoperative urinary leakage (P=0.04) and preoperative AUR (P<0.01).However,impact of postoperative urinary leakage on HPBT had no obvious clinical significance.Pairwise comparison of stent types indicated that,in terms of DPF,there were significant differences between F3 and F4,F3 and F4.7 (P=0.020,P=0.018) while no significant difference existed between F4 and F4.7 (P=1.000); in terms of HPBT,there was a significant difference between F3 and F4.7 (P=0.043).However,there was no significant differences between F4 and F3,F4 and F4.7 (P=0.052,P=1.000).Preoperative AUR was an independent risk factor for PHF (OR=3.750,95%CI:1.439-9.774,P=0.007).There were no significant differences in other variables.Conclusion Fever is a common complication after LP in children.With a significant impact on DPF and HPBT,preoperative AUR is an independent risk factor for PHF.Clinically,it is imperative to strengthen the postoperative temperature monitoring of children with preoperative AUR and stay on a high alert for the occurrence of symptomatic urinary tract infection.For children with asymptomatic AUR,prolonging preoperative antibiotic course until a normalization of urine routine may facilitate the control of postoperative fever.
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Memo
收稿日期:2024-5-26。
通讯作者:杨宁强,Email:yangnq0488@163.com