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. 2019 Sep 12;14(9):e0222570.
doi: 10.1371/journal.pone.0222570. eCollection 2019.

Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer

Shimpei Miyamoto  1 , Junichi Nakao  2 , Takuya Higashino  3 , Seiichi Yoshimoto  4 , Ryuichi Hayashi  5 , Minoru Sakuraba  3   6
Affiliations

Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer

Shimpei Miyamoto et al. PLoS One. .

Abstract

Background: The frequency of postoperative complications is used as an indicator of surgical quality; however, comparison of outcomes is hampered by a lack of agreement on the definition of complications and their severity. A standard grading system for surgical complications is necessary to improve the quality of clinical research and reporting in head and neck reconstruction.

Methods: The aim of this study was to compare postoperative morbidity after microvascular head and neck reconstruction between patients with versus without a history of prior radiation therapy (RT) by using the Clavien-Dindo classification. A group of 274 patients was divided into two cohorts based on the history of prior RT: the RT group included 79 patients and the non-RT group included 195 patients. Postoperative (30-day) complications were compared between the groups with a nonstandardized evaluation system and the Clavien-Dindo classification.

Results: The grades of complications according to the Clavien-Dindo classification were significantly higher in the RT group than in the non-RT group. The frequency of postoperative complications did not differ significantly between the groups according to the nonstandardized evaluation system.

Conclusions: The Clavien-Dindo classification could serve as a useful, highly objective tool for grading operative morbidity after microvascular head and neck reconstruction when comparing similar defects and methods of reconstruction. Widespread use of the Clavien-Dindo classification system would allow adequate comparisons of surgical outcomes among different surgeons, centers, and therapies.

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Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Perisanidis C, Herberger B, Papadogeorgakis N, Seemann R, Eder-Czembirek C, Tamandl D, et al. Complications after free flap surgery: do we need a standardized classification of surgical complications? Br J Oral Maxillofac Surg. 2012;50(2):113–8. 10.1016/j.bjoms.2011.01.013 . - DOI - PubMed
    1. Bosma E, Veen EJ, de Jongh MA, Roukema JA. Variable impact of complications in general surgery: a prospective cohort study. Can J Surg. 2012;55(3):163–70. 10.1503/cjs.027810 . - DOI - PMC - PubMed
    1. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187–96. 10.1097/SLA.0b013e3181b13ca2 . - DOI - PubMed
    1. Monteiro E, Sklar MC, Eskander A, de Almeida JR, Shrime M, Gullane P, et al. Assessment of the Clavien-Dindo classification system for complications in head and neck surgery. Laryngoscope. 2014;124(12):2726–31. 10.1002/lary.24817 . - DOI - PubMed
    1. Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. 1992;111(5):518–26. . - PubMed