Application of Clavien–Dindo Classification System for Complications of Minimally Invasive Percutaneous Nephrolithotomy

Abstract

Objective. To investigate the clinical applications of the Clavien–Dindo classification system (CDCS) in the assessment of perioperative complications in minimally invasive percutaneous nephrolithotomy (MPCNL). Methods. Totally, 390 patients with renal stones in our hospital from March 2015 to March 2020 were included for this study and then were divided into observation group (complication group, 78 cases) and control group (noncomplication group, 312 cases) according to the incidence of perioperative complications in CDCS. Single factor analysis and multivariate logistic regression analysis were used to analyze the risk factors of the perioperative complications of MPCNL. Results. The total incidence of complication in the 390 cases with MPCNL was 20.00% (78 cases) according to CDCS, among which the incidence of complications at grades I, II, III, IV, and V was 6.92% (27 cases), 8.21% (32 cases), 2.82% (11 cases), 1.79% (7 cases), and 0.26% (1 case), respectively. The proportion of patients, that aged >60 years, complicated with comorbidities, sophisticated calculi, the preoperative albumin level (<35 g/L), the operation time (>180 minutes), intraoperative bleeding volume (>300 mL), and hospitalization time (>7 days) in the observation group was significantly higher than that in the control group ((75.64% vs. 61.86%, 38.46% vs. 24.36%, 83.33% vs. 69.55%, 83.33% vs. 69.55%, 70.51% vs. 30.76%, 53.85% vs. 36.54%, and 60.26% vs. 43.27%), all P < 0.05). Multivariate logistic regression analysis showed that gender, associated comorbidities, preoperative albumin level, calculus complexity, operation time, and intraoperative bleeding volume (>300 mL) were correlated with the occurrence of complications ( P ≤ 0.001, 0.001, 0.001, 0.001, 0.003, and 0.001 respectively). Conclusion. The CDCS can give standard and more comparative criteria for the assessment of perioperative complications, which will provide reference data for reducing complications and ensuring safety profiles in these high-risk patients.

Accurately Defining the Incidence and Associations of 90-Day Complications after Urethroplasty: Adverse Impact of Patient Comorbidities, Preoperative Bacteriuria and Prior Urethroplasty

“…14–17 Overall, the clinically significant complications of urethroplasty compare quite favorably when compared to other urological procedures of similar magnitude and intensity such as pyeloplasty, percutaneous nephrolithotomy, radical prostatectomy and complex scrotal surgery. 23–26…”

The Outcome of the Miniaturized Percutaneous Nephrolithotomy in Lateral Position with Guidance of Non-Rotational C-Arm

“…The Clavien-Dindo scoring system is currently used by many authors to evaluate complications of surgeries, including PCNL. 13 In the study being referred to, out of 69 cases, two had postoperative complications, accounting for a 2.9% rate. One case experienced bleeding that required intervention to block the artery, while seven cases had fever (which subsided after 2–5 days of antibiotic treatment).…”

Can automated CT body composition analysis predict high-grade Clavien–Dindo complications in patients with RCC undergoing partial and radical nephrectomy?

“…8 It is used to evaluate complications in many surgeries such as percutaneous nephrolithotomy and transrectal urethral prostate and bladder resection, especially laparoscopic and robotic uro-oncological surgeries, which are new technologies in the field of urology. [9][10][11][12] Our study examined the relationship between body composition analysis and complications according to the Clavien-Dindo classification in patients with RCC nephrectomy.…”

“…8 It is used to evaluate complications in many surgeries such as percutaneous nephrolithotomy and transrectal urethral prostate and bladder resection, especially laparoscopic and robotic uro-oncological surgeries, which are new technologies in the field of urology. 9–12…”