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


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


Zdroje

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PLOS One


2019 Číslo 9

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