Key result
Targeting 37°C intraoperative core temperature cuts postoperative myocardial injury ~74% versus routine thermal management.
Why the study?
Intraoperative hypothermia is common during laparoscopic radical resection for colorectal cancer, and the effectiveness of maintaining different intraoperative core temperature targets in reducing postoperative myocardial injury required evaluation.
Does intensive or aggressive intraoperative thermal management reduce postoperative myocardial injury in patients undergoing laparoscopic radical resection for colorectal cancer?
RCT (n=144)
1:1:1
Does intensive or aggressive intraoperative thermal management reduce postoperative myocardial injury in patients undergoing laparoscopic radical resection for colorectal cancer?
Absolute Event Rate: 6.5% vs 25%
p-value: p=<.05
Targeting an intraoperative core temperature of 37°C significantly reduces postoperative myocardial injury compared to routine thermal management in patients undergoing colorectal cancer resection.
Warrants intensive temperature targets in laparoscopic colorectal resection; reinforces normothermia to reduce myocardial injury in noncardiac surgery.
Background: Intraoperative hypothermia is common in patients undergoing laparoscopic radical resection for colorectal cancer. This study evaluated the effectiveness of maintaining 2 different intraoperative core temperature targets (36°C and 37°C) compared with routine thermal management in reducing postoperative myocardial injury in this patient population. Methods: In this randomized controlled trial, A total of 144 patients were randomly assigned to 1 of 3 groups: routine (target nasopharyngeal temperature ≥35°C), aggressive (≥36°C), or intensive (37°C) thermal management, utilizing a forced-air warming blanket and warm-water mattress. The primary outcome was postoperative myocardial injury, defined as a cardiac troponin I (cTnI) concentration of 0.04 ng/mL or greater. Secondary outcomes included severe arrhythmia, metabolic acidosis, shivering, and Quality of Recovery-15 (QoR-15) scores. Results: Postoperative cTnI levels were lower in the aggressive and intensive groups than in the routine group ( P <.05). The incidence of myocardial injury was significantly lower in the intensive group than in the routine group (6.5% vs 25.0%; P <.05). The aggressive group had a lower incidence of metabolic acidosis than the routine group ( P < .05). The incidence of shivering was lower in both the aggressive and intensive groups than in the routine group ( P <.05) and was further reduced in the intensive group compared with that in the aggressive group ( P <.05). On postoperative day 1, QoR-15 scores were higher in the aggressive and intensive groups than in the routine group ( P < .05), with the intensive group demonstrating a higher score than the aggressive group ( P <.05). Conclusion: In patients undergoing laparoscopic radical resection for colorectal cancer, targeting a core intraoperative temperature of 37°C significantly reduces the incidence of postoperative myocardial injury.
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Wu et al. (2026) conducted an RCT in Colorectal cancer undergoing laparoscopic radical resection (n=144). Aggressive (≥36°C) or intensive (37°C) thermal management vs. Routine thermal management (target nasopharyngeal temperature ≥35°C) was evaluated on Postoperative myocardial injury (cardiac troponin I ≥0.04 ng/mL) (p=<.05). Targeting an intraoperative core temperature of 37°C significantly reduced the incidence of postoperative myocardial injury compared with routine thermal management (6.5% vs 25.0%; P<0.05).
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