Early post-operative fever after colorectal surgery in infants is common and rarely associated with infection
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Aug 2024 · 1 min read
In brief
In brief
This retrospective study of 68 infants undergoing colorectal reconstruction for Hirschsprung disease and anorectal malformations found that early post-operative fever occurred in 32% of cases but was rarely infectious in origin. The findings suggest most febrile infants can be safely observed rather than extensively evaluated.
- Early post-operative fever (<48h) occurs in 32% of infants after colorectal surgery but infection confirmed in only 3% of cases.
- Pre-existing colostomy and longer operative times significantly increase risk of early post-operative fever in infant colorectal procedures.
- Routine infectious work-up for early fever after infant ARM/HD repair may be unnecessary; observation-based approach warrants consideration.
- Most early post-operative fevers in infants undergoing colorectal reconstruction are non-infectious and self-limiting.
- Clinical decision tools needed to identify which febrile post-op infants require full septic work-up versus conservative monitoring.
Written by the GCMD Library team from the article.
Abstract
Purpose
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.
Methods
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.
Results
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).
Conclusion
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.