Assessment of Postoperative Complications in Abdominal Surgeries by Clavein-Dindo Classi?cation System in the Indian Hospital Setting

Assessment of Postoperative Complications in Abdominal Surgeries

Abstract

Background: Complications occur in every surgical department, there is no surgery without any complication. So surgical complications need to be classified and evaluated. When a new surgical procedure is introduced or when several surgical approaches exists for one procedure, there is a need to compare outcomes and complication for each specific approach in a sound and reproducible way. A new classification was initiated by Clavien and dindo which has been updated regularly. This classification is based on the type of therapy needed to correct the complication. The principle of the classification was to be simple, reproducible and applicable irrespective of the cultutral background. The objective is aim of our current study is to critically evaluate this classification and to correlate the classification grades in each patient and each procedure and test the easy usability in the Indian hospital setting. Subjects and Methods : A total of 100 cases diagnosed as abdominal pathology admitted in general surgical ward of Narayana Hospital which required elective laparotomy were studied. This evaluation provides strong evidence that the cassification is valid and applicable worldwide in many fields of surgery. No modification in the general principle of classification is warranted in view of its use in ongoing publications and trials. Results: This classification system helps in the exact analysis of each and every individual surgical postoperative complication by grading the complications and hence, lowering the occurrence of similar complications in the future surgical work. Conclusion: The Clavien-Dindo classification represents an objective and simple, way of reporting all complications in patients undergoing major abdominal surgeries. This classification system allows us to distinguish a normal postoperative course from any deviation and it satisfactorily distinguishes the severity of complications. Finally, according to our experience, this classification system seems to be of particular interest in comparing the various complications between different surgeries.