{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:18:19Z","timestamp":1787807899170,"version":"build-2784847793"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inadvertent perioperative hypothermia is common during minimally invasive rectal cancer surgery. We assessed whether a five-component multimodal temperature-management bundle was associated with improved perioperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective before-and-after study included 247 adults undergoing laparoscopic or robot-assisted radical rectal cancer surgery from 2021 to 2025 (pre-implementation, n = 123; post-implementation, n = 124). The primary outcome was any intraoperative nasopharyngeal core temperature &amp;lt;36.0\u00a0\u00b0C. Key secondary outcomes were minimum temperature, cumulative hypothermia duration, postanesthesia care unit (PACU) stay, shivering, and 30-day composite complications. Prespecified mixed-effects and multiplicity-adjusted analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Hypothermia occurred in 84\/123 patients (68.3%) before implementation and 19\/124 (15.3%) after implementation (absolute risk difference, \u221253.0 percentage points; 95% confidence interval [CI], \u221262.2 to \u221241.6;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). After implementation, minimum temperature was higher (36.05 \u00b1 0.22\u00a0\u00b0C vs 35.28 \u00b1 0.62\u00a0\u00b0C), hypothermia duration was shorter (0 [0\u20130] vs 42 [0\u201388] min), PACU stay was shorter (50 [43\u201360] vs 66 [55\u201379] min), shivering was less frequent (7.3% vs 42.3%), and composite complications were lower (17.7% vs 36.6%) (all adjusted\n                      <jats:italic>P<\/jats:italic>\n                      \u2264 0.001). The implementation period remained associated with lower hypothermia odds after adjustment (adjusted odds ratio, 0.066; 95% CI, 0.029\u20130.149).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Bundle implementation was associated with lower intraoperative hypothermia burden and improved selected recovery outcomes. The nonrandomized calendar-period design and possible secular confounding limit causal interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1888554","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:27:13Z","timestamp":1787804833000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypothermia and recovery outcomes before and after implementation of a multimodal perioperative temperature-management bundle in minimally invasive radical rectal cancer surgery"],"prefix":"10.3389","volume":"16","author":[{"given":"Qian","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Operating Room, Chengyang District People\u2019s Hospital","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Huai\u2019an Hospital of Huai\u2019an City (Huai\u2019an Clinical Medical College of Jiangsu University)","place":["Huai\u2019an, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operating Room, Chengyang District People\u2019s Hospital","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunmei","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Operating Room, Nantong Tongzhou Hospital of Traditional Chinese Medicine","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiefang","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Operating Room, Nantong Tongzhou Hospital of Traditional Chinese Medicine","place":["Nantong, Jiangsu, 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