Erdem Kinaci1, Mert Mahsuni Sevinc2, Savas Bayrak3, Emre Erdoğan4, Abdulkerim Ozakay5, Serkan Sari6. 1. Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: erdemkinaci@gmail.com. 2. Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: mertsevinc34@gmail.com. 3. Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: savasbayrak74@gmail.com. 4. Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: genelcerrahemreerdogan@gmail.com. 5. Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: kerimozakay@hotmail.com. 6. Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: drserkansari@yahoo.com.
Abstract
INTRODUCTION: The Classification of Intraoperative Complications (CLASSIC) is one of two recent classification systems for intraoperative adverse events (iAEs), featuring simple but inclusive definitions. No data have been reported regarding the relation between CLASSIC and postoperative course. The aim of the present study was to evaluate the relation between the grade of iAEs and the grade of postoperative complications in patients who underwent hepatopancreaticobiliary (HPB) surgery. METHODS: Demography, preoperative laboratory parameters, iAEs, postoperative complications, and intraoperative pH and lactate levels of patients who underwent HPB surgery between December 2014 and December 2015 were evaluated retrospectively. The recorded parameters were compared according to the grade of iAEs and the grade of postoperative complications described in the Accordion Severity Classification of Postoperative Complications. RESULTS: Fifty-eight patients were considered. Mean age was 56 ± 15, 21 female vs. 37 male, 47 malign vs. 11 benign. Demographic features and preoperative status of the patients, and the presence of intraoperative acidosis were not significantly related to the grade of iAEs or postoperative complications. The grade of iAEs was directly proportional to the grade of postoperative complications (p = 0.031). Although it is not statistically significant, lactate level at the end of operation had a potential to predict the postoperative course (p = 0.057). CONCLUSIONS: The grade of iAEs has a predictive value for the grade of postoperative complications in HPB surgery patients; hence, high grade of iAEs is significantly related to high grade of postoperative complications. Lactate level at the end of operation has the potential to predict the postoperative course.
INTRODUCTION: The Classification of Intraoperative Complications (CLASSIC) is one of two recent classification systems for intraoperative adverse events (iAEs), featuring simple but inclusive definitions. No data have been reported regarding the relation between CLASSIC and postoperative course. The aim of the present study was to evaluate the relation between the grade of iAEs and the grade of postoperative complications in patients who underwent hepatopancreaticobiliary (HPB) surgery. METHODS: Demography, preoperative laboratory parameters, iAEs, postoperative complications, and intraoperative pH and lactate levels of patients who underwent HPB surgery between December 2014 and December 2015 were evaluated retrospectively. The recorded parameters were compared according to the grade of iAEs and the grade of postoperative complications described in the Accordion Severity Classification of Postoperative Complications. RESULTS: Fifty-eight patients were considered. Mean age was 56 ± 15, 21 female vs. 37 male, 47 malign vs. 11 benign. Demographic features and preoperative status of the patients, and the presence of intraoperative acidosis were not significantly related to the grade of iAEs or postoperative complications. The grade of iAEs was directly proportional to the grade of postoperative complications (p = 0.031). Although it is not statistically significant, lactate level at the end of operation had a potential to predict the postoperative course (p = 0.057). CONCLUSIONS: The grade of iAEs has a predictive value for the grade of postoperative complications in HPB surgery patients; hence, high grade of iAEs is significantly related to high grade of postoperative complications. Lactate level at the end of operation has the potential to predict the postoperative course.
Authors: Salome Dell-Kuster; Nuno V Gomes; Larsa Gawria; Soheila Aghlmandi; Maame Aduse-Poku; Ian Bissett; Catherine Blanc; Christian Brandt; Richard B Ten Broek; Heinz R Bruppacher; Cillian Clancy; Paolo Delrio; Eloy Espin; Konstantinos Galanos-Demiris; I Ethem Gecim; Shahbaz Ghaffari; Olivier Gié; Barbara Goebel; Dieter Hahnloser; Friedrich Herbst; Ioannidis Orestis; Sonja Joller; Soojin Kang; Rocio Martín; Johannes Mayr; Sonja Meier; Jothi Murugesan; Deirdre Nally; Menekse Ozcelik; Ugo Pace; Michael Passeri; Simone Rabanser; Barbara Ranter; Daniela Rega; Paul F Ridgway; Camiel Rosman; Roger Schmid; Philippe Schumacher; Alejandro Solis-Pena; Laura Villarino; Dionisios Vrochides; Alexander Engel; Greg O'Grady; Benjamin Loveday; Luzius A Steiner; Harry Van Goor; Heiner C Bucher; Pierre-Alain Clavien; Philipp Kirchhoff; Rachel Rosenthal Journal: BMJ Date: 2020-08-25
Authors: Gabby T J A Reijnders-Boerboom; Esmee V van Helden; Robert C Minnee; Kim I Albers; Moira H D Bruintjes; Albert Dahan; Chris H Martini; Frank C H d'Ancona; Gert-Jan Scheffer; Christiaan Keijzer; Michiel C Warlé Journal: Perioper Med (Lond) Date: 2021-12-09