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Clavien-Dindo Classification

Masatoshi Nakagawa, Kazuyuki Kojima, Mikito Inokuchi, Keiji Kato, Hirofumi Sugita, Sho Otsuki, Kenichi Sugihara
Introduction The purpose of this study was to identify the frequency, severity, and risk factors of complications after open gastrectomy using the Clavien- Dindo classification because institution-specific criteria were mostly used in the previous articles. Materials and Methods All complication data were obtained from our prospectively collected database of open gastrectomy from January 1999 to December 2012 (n=539). Complications were classified into either major surgical complications such as pancreatic fistula, abdominal abscess, and anastomotic leakage, or others...
2016: Journal of Medical and Dental Sciences
(no author information available yet)
BACKGROUND: Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery. METHODS: Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable...
October 20, 2016: World Journal of Surgery
H Borgmann, M Rodríguez Socarrás, J Salem, I Tsaur, J Gomez Rivas, E Barret, L Tortolero
PURPOSE: To assess the feasibility, safety and usefulness of augmented reality-assisted urological surgery using smartglass (SG). METHODS: Seven urological surgeons (3 board urologists and 4 urology residents) performed augmented reality-assisted urological surgery using SG for 10 different types of operations and a total of 31 urological operations. Feasibility was assessed using technical metadata (number of photographs taken/number of videos recorded/video time recorded) and structured interviews with the urologists on their use of SG...
October 19, 2016: World Journal of Urology
Enio Campos Amico, José Roberto Alves, Samir Assi João, Priscila Luana Franco Costa Guimarães, Joafran Alexandre Costa de Medeiros, Élio José Silveira da Silva Barreto
Background: Hepatectomies have been increasingly recommended and performed in Brazil; they present great differences related to immediate complications. Aim: Assessing the immediate postoperative complications in a series of 88 open liver resections. Method: Prospective database of patients subjected to consecutive hepatectomies over nine years. The post-hepatectomy complications were categorized according to the Clavien-Dindo classification; complications presenting grade equal to or greater than 3 were considered major complications...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Gen Sugawara, Yukihiro Yokoyama, Tomoki Ebata, Takashi Mizuno, Tetsuya Yagi, Masahiko Ando, Masato Nagino
OBJECTIVE: To evaluate the optimal duration of antimicrobial prophylaxis in patients undergoing "complicated"' major hepatectomy with extrahepatic bile duct resection. BACKGROUND: To date, 4 randomized controlled trials (RCTs) have assessed the duration of antimicrobial prophylaxis after hepatectomy. However, all of these previous studies involved only "simple" hepatectomy without extrahepatic bile duct resection. METHODS: Patients with suspected hilar obstruction scheduled to undergo complicated hepatectomy after biliary drainage were randomized to 2-day (antibiotic treatment on days 1 and 2) or 4-day (on days 1 to 4) groups...
October 17, 2016: Annals of Surgery
Fernando Rotellar, Fernando Pardo, Alberto Benito, Gabriel Zozaya, Pablo Martí-Cruchaga, Francisco Hidalgo, Luis Lopez, Mercedes Iñarrairaegui, Bruno Sangro, Ignacio Herrero
BACKGROUND: The pure laparoscopic approach in right hepatectomy (LRH) for living donor liver transplantation (LDLT) is a controversial issue. Some authors have reported the procedure to be feasible but surgical outcomes and impact on short and long-term morbidity rates are yet to be determined. The aim of this study is to present the results of a preliminary 5 consecutive cases series of LRH for LDLT and to compare it with a successive cohort of open right hepatectomies (ORH) for LDLT...
October 17, 2016: Transplantation
Eun Young Kim, Hyun Woo Yim, Cho Hyun Park, Kyo Young Song
BACKGROUND: The clinical outcomes for postoperative complications (PCs) after gastrectomy depend on early diagnosis and intensive treatment. The aim of this study was to investigate the role of C-reactive protein (CRP) as an early predictor of PCs after gastrectomy for gastric cancer. METHODS: A total of 334 consecutive patients who underwent gastrectomy for gastric cancer in 2014 were enrolled in this study. Blood samples were obtained preoperatively, and at postoperative days 1 and 4 for the measurement of inflammatory markers (white blood cell, neutrophil, and platelet counts, and CRP)...
October 12, 2016: Surgical Endoscopy
María Díaz-Tobarra, Norberto Cassinello Fernández, Pablo Jordá Gómez, Mohammad Nebih Nofal, Raquel Alfonso Ballester, Joaquín Ortega Serrano
BACKGROUND: Surgical strategies in patients with BMI > 55 kg/m(2) are not well established. OBJECTIVES: The objective of this study is to compare the long term results and complications of 1- vs. 2-stage laparoscopic "Roux-en-Y″ gastric bypass (LRYGB) for patients with BMI > 55 kg/m(2). METHODS: Retrospective review of the complications and outcomes, between January 2007 and January 2010, for patients with a BMI > 55 kg/m(2) who underwent directly a LRYGB (1-stage) or a LRYGB as a 2nd stage of a laparoscopic sleeve gastrectomy (LSG)...
October 9, 2016: Obesity Surgery
Naomi E Verstegen, Alexander P W M Maat, Frank J Lagerwaard, Marinus A Paul, Michel I Versteegh, Joris J Joosten, Willem Lastdrager, Egbert F Smit, Ben J Slotman, Joost J M E Nuyttens, Suresh Senan
INTRODUCTION: The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC). METHODS: Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases...
October 3, 2016: Radiation Oncology
Georgios C Sotiropoulos, Nikolaos Machairas, Paraskevas Stamopoulos, Ioannis D Kostakis, Dimitrios Dimitroulis, Dimitrios Mantas, Gregory Kouraklis
BACKGROUND: Liver resection represents the treatment of choice for a small proportion of patients with hepatocellular carcinoma (HCC), amenable to surgery. The remarkable evolution in surgical techniques during the last decades introduced laparoscopic hepatectomy in the operative management of HCC, even in the presence of liver cirrhosis. No comparative study on laparoscopic or open liver resection for HCC has been conducted in Greece yet. METHODS: Patients undergoing liver resection for HCC by one senior hepatobiliary surgeon in our Institution during the period 11/2011-02/2016 were prospectively sampled and retrospectively analyzed for the purposes of this study...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Yusuke Watanabe, Kazuyoshi Nishihara, Sokichi Matsumoto, Takafumi Okayama, Yuji Abe, Toru Nakano
PURPOSE: To investigate the impact of postoperative complications on survival after curative resection for pancreatic cancer. METHODS: We reviewed retrospectively the medical records of 122 patients who underwent curative R0 resection for pancreatic cancer. Major complications included pancreatic fistula and hemorrhage of grade B or C according to the International Study Group of Pancreatic Fistula or Surgery criteria, and other complications of grade ≥III according to the Clavien-Dindo classification...
October 4, 2016: Surgery Today
R Di Micco, R L O'Connell, P A Barry, N Roche, F A MacNeill, J E Rusby
INTRODUCTION: Bilateral mammoplasty (BM) can optimise oncological safety and aesthetic outcomes in women with large or ptotic breasts whose tumour to breast volume ratio or tumour location pose a challenge to standard breast-conserving therapy (BCT) and for whom mastectomy (with or without reconstruction) may be the only alternative. METHODS: We undertook a comprehensive analysis of surgical outcomes (complications according to the Clavien Dindo classification), acute radiation morbidity (Radiation Therapy Oncology Group classification), oncological outcomes, and patient satisfaction (BREAST-Q questionnaire) in women who underwent BM for breast cancer (BC) from June 2009-November 2014...
September 9, 2016: European Journal of Surgical Oncology
Qi An, Tao Yu, Xianglong Cao, Hua Yang, Gang Zhao, Guoju Wu, Wenzhuo Jia, Gang Xiao
OBJECTIVE: To investigate the risk of postoperative complications in elderly colorectal cancer patients over 65 years with comorbid cardiovascular diseases. METHODS: A total of 381 elderly colorectal cancer patients over 65 years were pathologically diagnosed as colorectal adenocarcinoma and underwent the first surgery in Beijing Hospital during January 2013 and December 2014. Patients were divided into comorbid cardiovascular disease group (258 cases) and non-cardiovascular disease group (123 cases) according to the existence of comorbid cardiovascular disease...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Mingjun Wang, He Cai, Lingwei Meng, Yunqiang Cai, Xin Wang, Yongbin Li, Bing Peng
BACKGROUND: While an increasing number of open procedures are now routinely performed laparoscopically or robotically, minimally invasive pancreaticoduodenectomy (MIPD) remains one of the most challenging operations in abdomen. The aim of this study is to evaluate the current status and development of MIPD. METHODS: Embase, Medline, and PubMed databases were searched to identify studies up to and including Feb 2016 using the keywords "laparoscopic", or "laparoscopy", or "hand-assisted", or "minimally invasive", or "robotic", or "da vinci" combined with "pancreaticoduodenectomy", or "duodenopancreatectomy", "Whipple", or "pancreatic resection"...
September 21, 2016: International Journal of Surgery
Vidyadhar V Upasani, Oliver Birke, Kevin E Klingele, Michael B Millis
BACKGROUND: The modified Dunn procedure facilitates femoral capital realignment for slipped capital femoral epiphysis (SCFE) through a surgical hip dislocation approach. Iatrogenic postoperative hip instability after this procedure has not been studied previously; however, we were concerned when we observed several instances of this serious complication, and we wished to study it further. QUESTIONS/PURPOSES: The purpose of this study was to evaluate the frequency, timing, and clinical presentation (including complications) associated with iatrogenic instability after the modified Dunn procedure for SCFE...
September 20, 2016: Clinical Orthopaedics and related Research
Maurizio Carrino, Francesco Chiancone, Gaetano Battaglia, Luigi Pucci, Paolo Fedelini
INTRODUCTION: Distal extrusion of cylinders is a potential complication of the penile prosthesis implantation. Several methods have been proposed for repairing a distal penile erosion. We present our preliminary experience in "Distal corporoplasty" technique. METHODS: We enrolled 18 consecutive patients whose underwent a distal corporoplasty with simultaneous reimplantation of an "AMS 700 inflatable penile prosthesis (LGX)" from January 2013 to November 2015 at our hospital...
September 3, 2016: Urologia
Daisuke Hokuto, Takeo Nomi, Chihiro Kawaguchi, Takahiro Yoshikawa, Satoshi Yasuda, Shinsaku Obara, Ichiro Yamato, Takatsugu Yamada, Hiromichi Kanehiro, Yoshiyuki Nakajima
BACKGROUND: There are a few studies that have evaluated postoperative analgesia. The aim of this study was to evaluate the safety of administering celecoxib to manage postoperative pain after liver surgery. METHODS: The cases of patients who underwent liver resection at Nara Medical University from April 2008 to December 2015 were retrospectively analyzed. From January 2013 to December 2015, celecoxib was routinely administered (600 mg/day on postoperative day (POD) 2 and 400 mg/day from POD 3-7), whereas celecoxib was not administered from April 2008 to December 2012...
September 17, 2016: Digestive Surgery
Christos Kontovounisios, Emile Tan, Nikhil Pawa, Gina Brown, Diana Tait, David Cunningham, Shahnawaz Rasheed, Paris Tekkis
AIM: There is wide disparity in the care of patients with multi-visceral involvement of rectal cancer. The results of treatment of advanced and recurrent colorectal cancer are presented from a centre where a dedicated Multidisciplinary Team (MDT) is central to the management. METHOD: All consecutive MDT referrals between 2010 and 2014 were examined. Analysis was undertaken of the referral pathway, site, selection process, management decision, R0 resection rate, mortality / morbidity / Clavien-Dindo (CD) classification of morbidity, length of stay (LOS), and improvement of quality of life...
September 15, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Allison Barrie, Alexandra H Freeman, Liisa Lyon, Christine Garcia, Carol Conell, Laura H Abbott, Ramey D Littell, C Bethan Powell
STUDY OBJECTIVE: To compare intraoperative and postoperative surgical complications and outcomes between robotic-assisted and laparoscopic surgical management of endometrial cancer using a standardized classification system. DESIGN: Retrospective Cohort Study DESIGN CLASSIFICATION: II-2 SETTING: Integrated health care system in Northern California PATIENTS: 1433 women with a diagnosis of complex atypical hyperplasia and endometrial cancer managed by minimally invasive hysterectomy and surgical staging from January 2009 to January 2014...
September 9, 2016: Journal of Minimally Invasive Gynecology
Basilio Pirrera, Samuele Vaccari, Dajana Cuicchi, Ferdinando Lecce, Emilio De Raffele, Barbara Dalla Via, Marco Di Laudo, Valeria Tonini, Maurizio Cervellera, Bruno Cola
AIM: Colorectal cancer's (CRC) incidence occupies the second place among malignant tumours in men and the third place in women. The aging of the population raises new questions on the management of CRC in octogenarian patients. The objective of this study was to assess the influence of age (≥80) on treatment and surgical outcome of colorectal cancer. METHOD: In the period between October 1995 and April 2014, a total of 1397 patients underwent emergency and elective surgical interventions for CRC; the first group (Group-Older - GO) was composed of 291 patients 80 years or older (20...
September 9, 2016: International Journal of Surgery
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