Application and exploration of Clavien-Dindo Classification System for complications of minimally-invasive percutaneous nephrolithotomy

Abstract

Objective To analyse the Clavien-Dindo Classification System (CDCS) in assessment of perioperative complications in minimally-invasive percutaneous nephrolithotomy (MPCNL), and to provide the reference data for the assessment and management of perioperative complications of MPCNL. Methods Clinical data of 310 patients with renal stones who underwent MPCNL from December 2014 to December 2016 were retrospectively analyzed. Complications were recorded and assessed by using CDCS. According to the occurrence of complications within grade Ⅲ (including grade Ⅲ), the patients were divided into observation group (61 cases) and control group (249 cases). Multiple logistic regression analysis were used to analyze the factors influencing the occurrence of MPCNL. Results Totally 68 cases (21.94%) of the 310 patients had perioperative complications, the rate of gradeⅠ, Ⅱ, Ⅲ, Ⅳ and Ⅴ complications with CDCS was in 7.42% (23 cases), 9.03% (28 cases), 3.23% (10 cases), 1.94% (6 cases)and 0.32% (1 case) respectively. The patients'age (>60 years), complicated calculi, diabetic history, urinary tract infection, application of hormone drus, operation time (>180 minutes), the amount of bleeding (>150 mL), hospitalization time (>14 d) of the observation group were significantly higher than that of control group (P<0.05). Multiple logistic regression analysis showed that the age, complicated calculi, diabetic history, application of hormone drus, operation time, intraoperative bleeding volume were closely related to complications within Ⅲ grade of CDCS (P=0.043, 0.000, 0.005, 0.000, 0.005, 0.003). Conclusions CDCS can effectively indicate the related factors of MPCNL, and provide reference data for reducing the frequent complications, which have certain application value in clinic. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Postoperative Complications; Surgical Procedures, Minimally Invasive