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Urol Ann. 2013 Jan;5(1):18-22. doi: 10.4103/0974-7796.106959.

Assessment of Clavien-Dindo classification in patients >75 years undergoing nephrectomy/nephroureterectomy.

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  • 1Department of Urology, St James's University Hospital, Leeds, United Kingdom.

Abstract

INTRODUCTION:

There is a paucity of a standardized post-operative complications grading system in urology especially in the elderly population. Studies show satisfactory survival and oncological outcomes albeit with a slight increase in post-operative morbidity compared to younger patients. The Clavien-Dindo classification for post-operative complications is established as a valid system worldwide and applicable in many fields of surgery.

PURPOSE:

Retrospective assessment of post-operative complications in patients >75 years who underwent open/laparoscopic nephrectomy/nephroureterectomy for renal diseases and grading the post-operative complications according to the Clavien-Dindo classification.

MATERIALS AND METHODS:

Retrospective review of case notes was performed in patients >75 years who underwent a laparoscopic/open nephrectomy/nephroureterectomy between 2000 and 2008. Post-operative complications were graded according to the Clavien-Dindo classification.

RESULTS:

A total of 54 patients >75 years underwent nephrectomy/nephroureterectomy. 29 patients had laparoscopy and 25 had open surgery. Fifty one patients had a malignancy and 3 had benign diseases. Grade I, II, IIIa, IIIb and IVa were 25.6%, 41.1%, 7.7%, 7.7% and 17.9% respectively. No significant difference was noted in the 2 groups.

CONCLUSIONS:

We believe that in elderly patients, laparoscopic surgery can be offered safely without significantly increasing the surgical risks. The Clavien-Dindo classification is easy to use and effectively applied to categorize post-operative complications associated with nephrectomy/nephroureterectomy in elderly population. However, this system needs slight modification to incorporate intra-operative complications and large studies are needed to validate and standardize this classification for all urological procedures.

KEYWORDS:

Clavien-dindo; elderly; nephrectomy

PMID:
23662003
[PubMed]
PMCID:
PMC3643316
Free PMC Article

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