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This study aims to compare the strength of the classical Clavien-Dindo classification system (CDC), which is a Likert scale analysis versus the comprehensive complication index (CCI), a new quantitative evaluation system, in patients undergoing laparoscopic partial nephrectomy (LPN).
Prospectively collected data of sixty-two patients undergoing LPN with postoperative complications from November 2009 to August 2020 were evaluated retrospectively. Postoperative complications were classified according to the CDCs and calculated using the CCI calculator (https://www.assessurgery.com) quantitatively. Major complications were determined as ≥ grade 3 complications according to the CDC. The complexity of the renal mass was defined according to the RENAL nephrometry score. The cut-off value for CCI was analyzed by the ROC analysis technique. The significance level was taken as p<0.05.
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| Measure | Description | Time Frame |
|---|---|---|
| Postoperative complication | Abnormal clinical and laboratory findings that may be seen after surgery and require additional intervention, treatment, or follow-up | up to 3 months, postoperatively |
| Opertaion time | From first trocar incision to closure of all incisions | during the surgery (minute) |
| Estimeted blood loss | perioperative estimated blood loss | during the surgery (mL) |
| warm ischemia time | Its starts when the renal artery and vein are controlled and it ends when reperfusion of the graft kidney starts on the back table | during the surgery (minute) |
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Inclusion Criteria:
Exclusion Criteria:
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A retrospective analysis was carried out on 517 surgical procedures in 503 patients who underwent LPN between November 2009 and August 2020 in a tertiary university hospital. Sixty-two patients with postoperative complications were included in the study.
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| Name | Affiliation | Role |
|---|---|---|
| Ender Ozden, Prof. | Ondokuz Mayıs University, Faculty of Medicine, Department of Urology | Study Chair |
| Mehmet N Mercimek, Assoc. Prof. | Atasam Hospital, Departmen of Urology, Samsun, Turkey | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ondokuz Mayıs University, Department of Urology | Samsun | 55020 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31899103 | Background | Loffel LM, Gross T, Schneider MP, Burkhard FC, Thalmann GN, Bosshard P, Wuethrich PY, Furrer MA. Complication reporting with the Bern Comprehensive Complication Index CCI after open radical prostatectomy: A longitudinal long-term single-center study. Urol Oncol. 2020 Mar;38(3):79.e1-79.e8. doi: 10.1016/j.urolonc.2019.09.021. Epub 2019 Dec 31. | |
| 25379846 |
| Label | URL |
|---|---|
| Surgical technique | View source |
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| ID | Term |
|---|---|
| D007680 | Kidney Neoplasms |
| ID | Term |
|---|---|
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| Slankamenac K, Nederlof N, Pessaux P, de Jonge J, Wijnhoven BP, Breitenstein S, Oberkofler CE, Graf R, Puhan MA, Clavien PA. The comprehensive complication index: a novel and more sensitive endpoint for assessing outcome and reducing sample size in randomized controlled trials. Ann Surg. 2014 Nov;260(5):757-62; discussion 762-3. doi: 10.1097/SLA.0000000000000948. |
| 28597328 | Result | Kim TH, Suh YS, Huh YJ, Son YG, Park JH, Yang JY, Kong SH, Ahn HS, Lee HJ, Slankamenac K, Clavien PA, Yang HK. The comprehensive complication index (CCI) is a more sensitive complication index than the conventional Clavien-Dindo classification in radical gastric cancer surgery. Gastric Cancer. 2018 Jan;21(1):171-181. doi: 10.1007/s10120-017-0728-3. Epub 2017 Jun 8. |
| D052776 |
| Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |