Clavien–Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer

English version

Autoři: Shimpei Miyamoto ^aff001; Junichi Nakao ^aff002; Takuya Higashino ^aff003; Seiichi Yoshimoto ^aff004; Ryuichi Hayashi ^aff005; Minoru Sakuraba ^aff003
Působiště autorů: Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan ^aff001; Department of Plastic and Reconstructive Surgery, Nippon Medical School Hospital, Tokyo, Japan ^aff002; Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan ^aff003; Department of Head and Neck Oncology, National Cancer Center Hospital, Tokyo, Japan ^aff004; Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan ^aff005; Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan ^aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222570

Souhrn

Background

The frequency of postoperative complications is used as an indicator of surgical quality; however, comparison of outcomes is hampered by a lack of agreement on the definition of complications and their severity. A standard grading system for surgical complications is necessary to improve the quality of clinical research and reporting in head and neck reconstruction.

Methods

The aim of this study was to compare postoperative morbidity after microvascular head and neck reconstruction between patients with versus without a history of prior radiation therapy (RT) by using the Clavien–Dindo classification. A group of 274 patients was divided into two cohorts based on the history of prior RT: the RT group included 79 patients and the non-RT group included 195 patients. Postoperative (30-day) complications were compared between the groups with a nonstandardized evaluation system and the Clavien–Dindo classification.

Results

The grades of complications according to the Clavien–Dindo classification were significantly higher in the RT group than in the non-RT group. The frequency of postoperative complications did not differ significantly between the groups according to the nonstandardized evaluation system.

Conclusions

The Clavien–Dindo classification could serve as a useful, highly objective tool for grading operative morbidity after microvascular head and neck reconstruction when comparing similar defects and methods of reconstruction. Widespread use of the Clavien–Dindo classification system would allow adequate comparisons of surgical outcomes among different surgeons, centers, and therapies.

Klíčová slova:

Biology and life sciences – Anatomy – Medicine and health sciences – Pathology and laboratory medicine – Digestive system – Diagnostic medicine – Signs and symptoms – Clinical medicine – Oncology – Cancer treatment – Head – Gastrointestinal tract – Surgical and invasive medical procedures – Plastic surgery and reconstructive techniques – Clinical oncology – Radiation therapy – Neck – Jejunum – Otolaryngological procedures – Fistulas

Zdroje

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