Authors
Yunhui Chen, Haoyu Liu, Ge Gao, Li Li, Xiaodan Liu, Shouyan Wang
Published in
Journal of robotic surgery. Volume 20. Issue 1. Aug 12, 2026. Epub Aug 12, 2026.
Abstract
Elderly patients undergoing robot-assisted radical prostatectomy (RARP) are vulnerable to perioperative hypothermia. We developed and preliminarily evaluated a whole-process temperature-management protocol. Protocol development comprised evidence synthesis, interviews with 14 healthcare professionals, and two Delphi rounds with 21 experts. The non-concurrent evaluation included 40 control-period patients enrolled in September-October 2025 and 40 intervention-period patients enrolled in November-December 2025. The primary outcome was core-temperature trajectory across 10 measurements; secondary outcomes were hypothermia, shivering, thermal comfort, and satisfaction. The protocol comprised 8 domains, 20 s-level indicators, and 56 third-level indicators. The core-temperature group-by-time interaction was significant [F(2.92, 227.50) = 10.02; P < 0.001]. In a sensitivity analysis restricted to intraoperative nasopharyngeal measurements T1-T5, the interaction remained significant (likelihood-ratio χ²=12.14; df = 4; P = 0.016), with adjusted differences of 0.20-0.36 °C (all Holm-adjusted P ≤ 0.006). Hypothermia occurred in 7.5% versus 27.5% (risk difference, - 20.0% points; 95% CI, - 36.1 to - 3.2), and shivering in 5.0% versus 22.5% (risk difference, - 17.5% points; 95% CI, - 32.9 to - 2.1), during the intervention and control periods, respectively. The protocol was feasible to implement, and outcomes were more favorable during the intervention period. The non-concurrent design limits causal attribution; concurrent randomized studies are needed.
PMID:
42581188
Bibliographic data and abstract were imported from PubMed on 12 Aug 2026.
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