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Scholars Journal of Applied Medical Sciences | Volume-4 | Issue-06
A Prospective Observational Study- Assessment and Categorization of Urological Operative Complications as Per ClavienDindo Classification in Our Institution
Dr. Debi Prasad Das, Dr. Bastab Ghosh, Prof. Dilip Kumar Pal
Published: June 27, 2016 |
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DOI: 10.36347/sjams.2016.v04i06.001
Pages: 1869-1877
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Abstract
At present main methods of assessing quality of surgical results & audits are mortality and morbidity. In 1992
Pierre Alain Clavien proposed a therapy oriented classification of post-operative complication.This grading system is
well accepted worldwide as it is simple, reliable and valid. Our objectives are to assess and categorize urological
operative complications as per Clavien-Dindo classification and to assess complication rates in reference to age, body
mass index, American society of Anesthesiology score and comorbidities ( Diabetes, Hypertension ) and laparoscopic
versus endourological versus open procedures.We prospectively observed total 310 urological operations conducted in
our institute, aged 13-80 yrs,190 male(61.3%) 120 female (38.7%) ,open procedure(n 122),laparoscopic procedure (n 35),
endourological procedure(n153). We have assessed and categorized operative complications as per ClavienDindo
classification by detailed history, clinical examination and relevant investigations as required and also influence of
predictors like age, BMI, ASAscore, comorbidities ( Diabetes &Hypertension) and laparoscopic versus open surgical
procedures have been calculated.We observed total 64 complications(20.6%); gr I 62.5%,gr II 15.6%,gr III 12.5%,grIV
3.1%,grV 6.2%; and complications in laparoscopic (17%) and endourological procedure (17.6%)are significantly less
than open(35%). Age, BMI and comorbidities (Diabetes and hypertension) have significant influence on complication
rates.Most of the complications are grade- I. Laparoscopic and endourological procedures have fewer complications than
open procedure. Age, BMI and comorbidities (Diabetes and hypertension) have great influence on complications.