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. 2013 Jan;5(1):18-22.
doi: 10.4103/0974-7796.106959.

Assessment of Clavien-Dindo classification in patients >75 years undergoing nephrectomy/nephroureterectomy

Atif Khan  1 , Victor Palit, Andy Myatt, Jon J Cartledge, Anthony J Browning, Adrian D Joyce, Chandra Shekhar Biyani
Affiliations

Assessment of Clavien-Dindo classification in patients >75 years undergoing nephrectomy/nephroureterectomy

Atif Khan et al. Urol Ann. 2013 Jan.

Abstract

Introduction: There is a paucity of a standardized post-operative complications grading system in urology especially in the elderly population. Studies show satisfactory survival and oncological outcomes albeit with a slight increase in post-operative morbidity compared to younger patients. The Clavien-Dindo classification for post-operative complications is established as a valid system worldwide and applicable in many fields of surgery.

Purpose: Retrospective assessment of post-operative complications in patients >75 years who underwent open/laparoscopic nephrectomy/nephroureterectomy for renal diseases and grading the post-operative complications according to the Clavien-Dindo classification.

Materials and methods: Retrospective review of case notes was performed in patients >75 years who underwent a laparoscopic/open nephrectomy/nephroureterectomy between 2000 and 2008. Post-operative complications were graded according to the Clavien-Dindo classification.

Results: A total of 54 patients >75 years underwent nephrectomy/nephroureterectomy. 29 patients had laparoscopy and 25 had open surgery. Fifty one patients had a malignancy and 3 had benign diseases. Grade I, II, IIIa, IIIb and IVa were 25.6%, 41.1%, 7.7%, 7.7% and 17.9% respectively. No significant difference was noted in the 2 groups.

Conclusions: We believe that in elderly patients, laparoscopic surgery can be offered safely without significantly increasing the surgical risks. The Clavien-Dindo classification is easy to use and effectively applied to categorize post-operative complications associated with nephrectomy/nephroureterectomy in elderly population. However, this system needs slight modification to incorporate intra-operative complications and large studies are needed to validate and standardize this classification for all urological procedures.

Keywords: Clavien-dindo; elderly; nephrectomy.

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Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
Complications according to histological grades
Figure 2
Figure 2
BMI and complications in laparoscopic and open groups combined
See this image and copyright information in PMC

References

    1. Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. 1992;111:518–26. - PubMed
    1. Clavien PA, Barkun J, de Oliviera ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: Five-year experience. Ann Surg. 2009;250:187–96. - PubMed
    1. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13. - PMC - PubMed
    1. Breitenstein S, DeOliveira ML, Raptis DA, Slankamenac K, Kambakamba P, Nerl J, et al. Novel and simple pre-operative score predicting complications after liver resection in non-cirrhotic patients. Ann Surg. 2010;252:726–34. - PubMed
    1. Seely AJ, Ivanovic J, Threader J, Al-Hussaini A, Al-Shehab D, Ramsay T, et al. Systematic classification of morbidity and mortality after thoracic surgery. Ann Thorac Surg. 2010;90:936–42. - PubMed