Clavien-Dindo classificationa: a tool to assess complications following surgical treatment in children with acute appendicitis

Abstract

Introduction. In pediatrics, there are few standard criteria to classify and consolidate postoperative complications, particularly in appendectomy, where according to the literature, complications range from 5% to 30%.Methods. A cross-sectional, observational, retrospective study of patients undergoing surgery as a result of suspected acute appendicitis (AA) from December 2018 to January 2020 was carried out. Complications were grouped and consolidated according to the Clavien-Dindo (CD) classification. Postoperative complications and factors involved were analyzed by conducting a bivariate and multivariate statistical study using SPSS statistical software, version 25.Results. A total of 124 patients were studied. Mean age was 9 years (3-14 years). 62% were boys, and 38% were girls. All patients underwent appendectomy -80.6% through laparotomy, and 19.4% through laparoscopy. 20% of patients had postoperative complications, which were grouped according to the CD classification (p = 0.002). Most complications were included in the CD I group (64%). Collections treated with antibiotic therapy were included in the CD II group (28%). Intra-abdominal collections requiring re-intervention for drainage purposes were included in the CD IIIb group (8%). The main factors driving complications were complicated AA (81% gangrenous and perforated) (p < 0.001) and progression time (80% >24 h of progression) (p = 0.036), which increased mean hospital stay by 7 ± 4 days (p = 0.016). 137 ± 37 CRP levels were associated with plastron identification (p < 0.001), whereas 109 ± 19 CRP levels were associated with peritonitis (p < 0.001).Conclusions. The Clavien-Dindo classification allows post-appendectomy complications in pediatric surgery to be classified using a common language, by associating complication grade with treatment complexity.

Changes in Levels of Serum Cytokines and Chemokines in Perforated Appendicitis in Children

“…In children with acute appendicitis, the surgical approach is not without risks or complications [ 10 , 11 ]. Perforated appendicitis can occur in 17% to 32% of adult patients [ 12 ] and 25.9% of children [ 13 ].…”

The safety and short-term effect of mixed approach in laparoscopic right hemicolectomy for right colon cancer compared with middle approach: a retrospective study

“…Postoperative data were recorded, including defecation time, postoperative hospital stay and postoperative complications. Complications were graded according to Clavien-Dindo classification [ 13 ].…”