CC BY-NC-ND 4.0 · Urol Colomb 2018; 27(03): 294-298
DOI: 10.1055/s-0038-1656559
Case Report | Caso Clínico
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Thermographic Patterns for Real-time Intraoperative Monitoring of Testicular Reperfusion Following Surgical Testicular Detorsion

Patrón termográfico en tiempo real para el monitoreo de reperfusión testicular intraoperatorio en caso de torsión testicular
Nicolas Fernandez
1  Division of Urology, Department of Surgery, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada
2  Division of Urology, Department of Surgery, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
,
Armando Lorenzo
1  Division of Urology, Department of Surgery, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada
,
Anne-Sophie Blais
1  Division of Urology, Department of Surgery, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada
,
Clyde Matava
3  Department of Anesthesia, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada
› Author Affiliations
Further Information

Publication History

19 December 2017

09 March 2018

Publication Date:
29 May 2018 (eFirst)

Abstract

A 5-year-old patient presents to the emergency department with testicular torsion. Intraoperative sequential infrared thermographic images were registered in real-time using a FLIR One (FLIR Systems, Inc., Wilsonville, OR, US) infrared camera. The temperatures of the scrotum and the testis prior to scrotal exploration were 43.6°C on the affected side, and 41.7°C on the contralateral side. The core temperature of the patient was 36.8°C. Immediately after the tunica vaginalis had been opened and the testis had been brought out through the incision, the temperature of the testicle was 31.5°C. After 30 seconds of being detorted, the temperature increased to 34.3°C. The use of intraoperative infrared thermographic imaging helps to detect discrete changes in testicular temperature, which suggests it may be useful to objectively assess reperfusion. Future studies will require more patients to correlate postoperative blood flow to the injured testis as well as volume changes after surgery to see if the intraoperative thermography findings can be used as a predictive tool for postoperative outcomes.

Resumen

Paciente de 5 años de edad con historia de 8 horas de torsión testicular es llevado a cirugía. Se realiza registro imaginonlógico termográfico seriado en tiempo real del momento en que se realiza la destorsión utilizando una cámara infrarroja FLIR One. La temperatura escrotal previa a la cirgía era de 43,6°C del lado afectado y 41,7°C del lado sano. La temperatura corporal del paciente era de 36,8°C. Inmediatemente el testiculo fue extraído y previo a la destorsión, la temperatura era de 31,5°C. A los 30 segundos de la destorsión la temperatura aumentó a 34,3°C. El uso de termografía intraoperatoria permite identificar cambios discretos que se correlacionan con aumento del flujo testicular. Estudios futuros se enfocarán en establecer variables predictorias de sobrevida del parenquima testicular al igual que definir variables intraoperatorias para definir manejos quirurgicos como orquiectomia, preservación con flap de tunica vaginal entre otras.