What Is a Surgical Complication?

Dindo, Daniel; Clavien, Pierre‐Alain

doi:10.1007/s00268-008-9584-y

Cited by 231 publications

(170 citation statements)

References 23 publications

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“…They were recorded retrospectively on the basis of patient records using the Charlson Comorbidity Index [10] and Cumulative Illness Rating Scale Geriatrics (CIRS-G) [11,12] in the diagnosis sheets provided for this purpose [10][11][12][13][14]. A surgical complication was defined as "each and any deviation from the ideal postoperative course which is not inherent to the procedure and excludes failure of the therapy" [17] and systematically classified according to the valid system of Clavien and Dindo (CD) which is recommended by the professional societies [9] and very frequently used in surgical medicine [6,8,14,[18][19][20]. The observation time encompassed the postoperative inpatient stay and a 48-h readmission interval.…”

Section: Definitions and Registration Systemmentioning

confidence: 99%

Gynaecological Prolapse Surgery in Very Old Female Patients

Mothes

Kwetkat

Radosa

et al. 2016

Geburtshilfe Frauenheilkd

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Hintergrund: Ziel ist der Vergleich von hochaltrigen Patientinnen mit einer jüngeren Kontrollgruppe nach Deszensuschirurgie hinsichtlich Komorbidität und Komplikationen. Methode: Im Fallkontrolldesign erfolgte die Analyse konsekutiver Daten nach Deszensuschirurgie ab 80. Lebensjahr und einer Kontrollgruppe mittels Clavien-Dindo-(CD-)Klassifikation chirurgischer Komplikationen, Charlson Comorbidity Index und Cumulative Illness Rating Scale Geriatrics (CIRS-G). Statistik: Studentʼs t-, Fisherʼs Exactund Mann-Whitney U-Tests. Ergebnisse: Es wurden n = 57 vs. n = 60 Operationen erfasst. Bei Hochaltrigen lag häufiger ein Grad-IV-Prolaps vor (p < 0,001), es erfolgte häufiger eine apikale Fixation (p < 0,001), die OP-Zeiten unterschieden sich nicht. Bei Hochaltrigen fanden sich 21% CD-II + III-Komplikationen, in der Kontrollgruppe 6,6 % (p = 0,031). In beiden Gruppen traten keine CD-IV-und-V-Komplikationen auf, die Verweildauer lag bei 5 (± 1) vs. 4,1 (± 0,8; p < 0,001) Tagen, eine stationäre Weiterbetreuung erfolgte häufiger bei hochaltrigen Patientinnen (p < 0,001). Die Komorbidität Hochaltriger unterschied sich von der Kontrollgruppe in der Anzahl (median 2,0 vs. 1,5; p < 0,001), im CIRS-G (4,1 ± 2,2 vs. 2,4 ± 1,7; p < 0,001) und im Charlson-Index (1,6 ± 1,6 vs. 0,5 ± 0,7; p < 0,001). Schlussfolgerungen: Ein Deszensus kann bei hochaltrigen Patientinnen sicher chirurgisch versorgt werden. Komplikationen erreichten in keinem Fall Intensivtherapiepflichtigkeit oder Lebensbedrohlichkeit, führten aber zu einer verlängerten Verweildauer und häufiger zu geriatrischer oder internistischer stationärer Weiterbehandlung.

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Section: Definitions and Registration Systemmentioning

confidence: 99%

Gynaecological Prolapse Surgery in Very Old Female Patients

Mothes

Kwetkat

Radosa

et al. 2016

Geburtshilfe Frauenheilkd

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“…Surgeons may prefer a more conservative approach when deciding on the treatment of other patients due to these situations. The depression and burnout syndrome developing in the surgeon due to surgical complications not only affect the surgeon and his family but also adversely affect the surgeon's clinical performance and patient safety (7).…”

Section: Discussionmentioning

confidence: 99%

A surgeon’s nightmare: Complications

Gemici

Okuş

Yıldız

et al. 2015

UCD

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Objective: Our study aimed to determine the physically and psychologically most difficult complication resulting in chronic discomfort and occurring sensationally in the postoperative period of operations performed frequently in the daily surgical routine. Material and Methods:We performed a survey among surgeons who participated in the 19 th National Surgery Congress. The questions were related to the complications encountered in the frequent procedures performed in the daily general surgery routine and resulting in chronic life discomfort but which are not life threatening. Three hundred and sixty general surgeons participated in the survey and they were asked which complication among the given ones was the most difficult for a surgeon to manage physically and psychologically. The received answers were recorded and evaluated with descriptive statistical analysis.Results: Among the surgeons who participated in the survey, 345 were male (96%) and 15 female (4%); 218 (61%) general surgeons served in universities whereas 112 (30%) surgeons served in other public institutes and 30 (9%) served in private hospitals. With regard to the ranking of the complications that are most difficult to manage by the surgeons, pain and hemorrhage developing after hemorrhoidectomy were in the first place with 90 (25%) votes, whereas persistent hypocalcemia after total thyroidectomy was in the second place with 73 (20%) votes. Furthermore, 286 (80%) surgeons stated that the complications did not discourage them from performing the same operation again. Conclusion:Our results indicated that among the determined complications of operations performed in daily surgery routine, pain and hemorrhage developing after hemorrhoidectomy were the most difficult to manage. In addition, it was observed that complications did not discourage surgeons to perform the same operation again, contrary to popular belief.

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“…The EPR system also contained a preoperative anesthetic assessment that included a thorough systematic clinical history, microbiological records, blood transfusion records, histopathology, cytopathology, hematology, and biochemistry results. All clinical documentation of the patients was reviewed for Clavien-Dindo 6 grade II complications and above for 30 days following surgery.…”

Section: Methodsmentioning

confidence: 99%

The effect of obesity on clinical and economic outcomes in robotic endometrial cancer surgery

Ind

Marshall

Hacking

et al. 2017

RSRR

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Abstract:The aim of this study was to compare the financial and clinical outcomes in roboticassisted laparoscopic surgery for primary endometrial cancer between obese and nonobese women. The hospital finance department assessed the total admission costs for robotic surgery for endometrial cancer in 54 women. This included a subanalysis for costs over nine areas (ward and clinics, drugs and pharmacy, medical staff, theaters, blood products, imaging, pathology, rehabilitation therapy, and high dependency costs). Furthermore, a prospective collection of morbidity and surgical outcome data was performed. The study group included 21 nonobese and 33 obese women (body mass index >30). Obese women were more likely to stay for more than one night in hospital (20/ ). There were six Clavien-Dindo grade II complications in the obese group and two in the nonobese group. The average overall costs were £1,852 greater (95% CI £431-£3,277, P=0.012) in the obese group. Diabetes and hypertension were associated with increased costs, but obesity was the only independent variable. In conclusion, greater resource should be allocated to obese women undergoing primary surgery for endometrial cancer.

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What Is a Surgical Complication?

Cited by 231 publications

References 23 publications

Gynaecological Prolapse Surgery in Very Old Female Patients

Gynaecological Prolapse Surgery in Very Old Female Patients

A surgeon’s nightmare: Complications

The effect of obesity on clinical and economic outcomes in robotic endometrial cancer surgery

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