The Clavien-Dindo classification of surgical complications for procedures in gynaecological oncology

Abstract

Aims/objectives: This study assessed the application of the Clavien-Dindo classification of surgical complications to procedures in gynaecological oncology. We examined the frequency and severity of surgical complications using this ranking tool, which has become widely used in surgical specialties. Background: The Clavien-Dindo classification of surgical complications was introduced in 2004 to define and grade complications. It was initially applied to general surgical procedures, and later to urological, upper gastrointestinal, pancreatic and liver surgery. Use of the ranking system has shown that complication severity is significantly correlated with complexity of surgery and length of hospital stay. Materials and methods: 239 cases in one gynaecological oncology unit, over a 6-month time period, were examined retrospectively. Variables recorded included the type of malignancy, surgical procedure performed, ASA classification and comorbidities. Target variables included surgical complications, subdivided into mild (Clavien-Dindo grade I–II) and severe complications (grade III–V), as well as length of stay in hospital. Results, summary/conclusions: There were a total of 102 complications recorded (overall rate of complications was 43.2%). This included 88 mild complications (36%) and 14 severe complications (5.9%). There was a positive correlation between severity of surgical complication and length of hospital stay. The mean length of stay in patients with mild complications was 7.6 days, while for severe complications it was 31.4 days. By applying the Clavien-Dindo classification to surgical complications, our unit was able to more accurately assess surgical morbidity and robustly audit services.