Determinants of outcome in gastrointestinal perforations with special reference to clavien–dindo classification of surgical complications: Experience of a Single Institute in Central Rajasthan

Singh, Amit; Porwal, Rekha; Gupta, Hanuman Prasad; Sharma, Anil Kumar; Kumawat, Ghanshyam

doi:10.4103/2278-9596.202365

Cited by 4 publications

(3 citation statements)

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“…In this series overall mortality rate 12.0%, which is consistently reported in other studies as Singh A et al 17 reported mortality rate 10.85%.…”

Section: Grade IIIsupporting

confidence: 87%

“…In this study 30.0% patients were underwent emergency surgery and 70.0% patients underwent elective surgery, further procedures were applied according to need of surgery. Comparable findings were reported by Singh A et al 17 In this study postoperative outcome was assessed according to the Clavien-Dindo scoring system, our results did not completed all requirements of Clavien-Dindo scoring system, but some complications were found according to classification of it, and on that basis patients were divided in grading.…”

Section: Grade IIIsupporting

confidence: 73%

“…Majority of the cases 16 (32.0%) were found without complications, 12 (24.0%) with grade II, followed by 10 (20.0%) were with grade I, 04 (08.0%) were with grade III, only 2 (4.0%) cases were found with grade IV and 06 (12.0%) cases were died during follow up and those were with grade V. Comparable findings were reported in the studies of Singh A et al 17 Casadei R et al, 18 and Clavien PA et al 19 , but results on some places are consistent and on some places are inconsistent.…”

Section: Grade IIIsupporting

confidence: 64%

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Gastrointestinal Surgeries

Bhanbhro

Shah

Memon³

et al. 2018

TPMJ

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Objectives: To determine the operative findings of patients underwentgastrointestinal surgeries and postoperative outcome according to Clavien-Dindo system. StudyDesign: Prospective study. Setting: Isra University Hospital Hyderabad and LUMHS Jamshoro/Hyderabad. Period: One year duration from 2014 to 2015. Material and methods: Total 50patients were included those were underwent Gastrointestinal Surgery. After taking detailedhistory and clinical examination, relevant investigations i.e. CBC, abdominal X-ray, MethyleneBlue Test to confirm the leaks and abdominal ultrasound were done. All operative findingsand postoperative outcome according to Clavien-Dindo system was recorded in the proforma.After collection of data was analysed by (SPSS) version16.0. Results: Total 50 cases studied,their mean age was 46.6+9.7 years, male were found in majority 36 (72.0%) while female were14 (28.0%). Most common diagnosis in of patients those underwent gastrointestinal surgerieswere typhoid perforation 22.0%, tuberculosis 18.0%, Duodenal perforation 20.0% and intestinalobstruction was 10.0%. Postoperative outcome was assessed according to the Clavien-Dindoscoring system as; majority of the cases 16 (32.0%) were found without complications, 12(24.0%) with grade II, followed by 10 (20.0%) were with grade I, 04 (08.0%) were with grade III,only 2 (4.0%) cases were found with grade IV and 06 (12.0%) cases were died during follow upand those were with grade V. Conclusion: It is concluded that most common operative findingswere typhoid perforation, tuberculosis, duodenal perforation and intestinal obstruction findingsinpatients those underwent gastrointestinal surgeries. According to the Clavien-Dindo scoringsystem and majority of the cases were with grade I and grade II and 6 cases were died thosewere enrolled as grade V.

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“…In this series overall mortality rate 12.0%, which is consistently reported in other studies as Singh A et al 17 reported mortality rate 10.85%.…”

Section: Grade IIIsupporting

confidence: 87%

Section: Grade IIIsupporting

confidence: 73%

Section: Grade IIIsupporting

confidence: 64%

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Gastrointestinal Surgeries

Bhanbhro

Shah

Memon³

et al. 2018

TPMJ

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“Clinical Study of Clavien-Dindo Classification to Assess the Grades of Complication and Factors Responsible in Cases of Gastrointestinal Perforations in a Tertiary Care Centre”

Deshwali¹,

Sharma²

2021

Global Journal for Research Analysis

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INTRODUCTION Perforation peritonitis is one of the most common surgical emergencies across the globe. Gastrointestinal perforations have very high morbidity and mortality rates, irrespective of the type of operative procedure performed. The Clavien-Dindo system is nowadays widely used for complications after surgery for grading adverse events (i.e. complications) which occur as a result of surgical procedures and has become the standard classification system for many surgical specialties for open as well as laparoscopic surgeries . In this study, an attempt is made to find out various preoperative and intra operative factors that may responsible for adverse outcome and to identify the best management that could decrease the complication rate with special reference to CLAVIEN-DINDO classification. MATERIALS AND METHODS We did an observational study of 60 perforation peritonitis patients admitted in Department of Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Indore, M.P. between November 2017 to May 2019(1 and 1/2 Year) on the basis of Clavien-Dindo classification.All were studied with respect to clinical features, time of presentation, comorbid conditions, investigations, intervention done, operative findings and postoperative course and all the data was entered in preformed proforma RESULTS Total 60 patients of perforation peritonitis admitted and treated in the department, During the period of November 2017 to May 2019. End of the study concludes the following points: • In my study, most of the cases were between age group 20-39(50%). more common in males 41 (68.33%). who presented after 3 days from onset of symptoms 20 (33.33%) all of them had complications 20(100%). P Value was<0.001 which is significant. In 16 (26.6%) patient’s comorbid conditions were present, out of them 12 (75%) patients were haemodynamically unstable and 9(56.25%) patient expired.In 29 (48.33%) patient size of perforation was more than 1 cm out of which complication observed in 28(96.55%) patient.. P Value was <0.001 which is significant. In 10 (16.66%) patients multiple perforations were found out of which 09 (90%) patients were unstable. Complication occurred in 09(90%) patients . In this group 6(60%) patient expired. P Value was 0.001 which is significant . In 24(40%) patients more than 500 ml intraperitoneal collection was found, out of which complications developed in all 24(100%) patients,. Chi Square Value was 42.8 and P Value was<0.001 which is significant. Complication according to clavien -dindo classification 14 out of 60 (23.33%) patients had no complications, 4 (6.66%) had grade I complication, 5 (8.33%) had grade II complications, 12 (20%) had grade III complications, 11 (18.33%) had grade IV complications, and 14 (23.33%) had grade V complication rates . CONCLUSION Post-operative complications increase due to comorbid conditions, size and number of perforations and it also affects the outcome of the patient. It is observed that with the increase in contamination (intraperitoneal collection) morbidity increases.For the classification of complications, a new system is proposed by Clavien–Dindo which is very helpful during perforation surgery, it is used in all over the world and facilitates in comparisons or evaluation of various surgical . The new classification mainly focuses on the medical perspective, with a major emphasis on the risk, type of anaesthesia and procedures or therapy used to correct a complication. We therefore recommend the use of clavien-dindo classification of complications.

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“A Study on Grading of Post Operative Complication After Exploratory Lapratomy According to Clavein-Dindo System”

Kasale

Kathare²

2022

PIJR

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Aim And Objectives: Post-operative surgical complications are common in every surgery. The compulsive postoperative surveillance is mandatory to identify and address post-operative complications at the earliest with the help of simple,convenient,reproducible and comprehensive logical system.This study is aimed to grade post-operative complications and incidence of wound infection after exploratory laparotomy according to clavien-dindo classification. Material And Methods: This is a prospective study of 70 patients with acute abdominal conditions who required emergency exploration of abdomen.This study was conducted inVDGMC Latur from December 2019 to May 2021. Results: Out of 70 patients 46 were males and 34 were females. Mean age of our study population was 49.7 years (range 13-79). Majority of study population had exploratory laparotomy due to gastric perforation (18.6 %) and intestinal obstruction (18.6 %).11 patients had no complications and remaining 59 patients developed complications.G1 includes 34.2%, G2 includes 25.7%, G3a includes 5.7%, G3b includes 4.3%, G4a includes 9%, G4b includes 1.4% and G5 includes 2.9%.21.4% patients had surgical site infection and Grade 1 complications were more common in our study. Conclusion: We concluded that clavien-dindo classification is simple, easy and effective tool useful for analyzing, reporting and addressing complications after exploratory laparotomy for abdominal pathology.

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Determinants of outcome in gastrointestinal perforations with special reference to clavien–dindo classification of surgical complications: Experience of a Single Institute in Central Rajasthan

Cited by 4 publications

References 1 publication

Gastrointestinal Surgeries

Gastrointestinal Surgeries

“Clinical Study of Clavien-Dindo Classification to Assess the Grades of Complication and Factors Responsible in Cases of Gastrointestinal Perforations in a Tertiary Care Centre”

“A Study on Grading of Post Operative Complication After Exploratory Lapratomy According to Clavein-Dindo System”

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