Analysis of Clavien-Dindo classification and its prognosis factors of complications after laparoscopic right hemicolectomy
10.3760/cma.j.issn.0529-5815.2018.12.005
- VernacularTitle: 腹腔镜右半结肠切除术后并发症的Clavien-Dindo分级及预后因素分析
- Author:
Lai XU
1
;
Huizhong QIU
;
Bin WU
;
Guole LIN
;
Junyang LU
;
Guannan ZHANG
;
Xiyu SUN
;
Yi XIAO
Author Information
1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
Colonic neoplasms;
Colectomy;
Postoperative complications
- From:
Chinese Journal of Surgery
2018;56(12):900-905
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the Clavien-Dindo classification of complications after right hemicolectomy and to explore the prognosis factors for postoperative complications.
Methods:The retrospective case-control study was adopted. The clinical data of 176 patients who underwent right hemicolectomy at Department of General Surgery, Peking Union Medical College Hospital from October 2016 to February 2018 were collected. There were 95 male and 81 female patients with age of (62.4±12.7) years. The Clavien-Dindo classification was used for postoperative complications. Univariate and multivariate analysis were used to analyze the independent prognosis factors of complications after right colon resection.
Results:Of the 176 patients, 2 patients had intraoperative complications (1.1%) and 39 patients had postoperative complications (22.2%), of which 10 cases had more than two complications, with a total of 53 complications. The proportions of Clavien-Dindo grade Ⅰ, Ⅱ, Ⅲ and Ⅳ complications were 41.5% (22/53), 49.1% (26/53), 7.5% (4/53), and 1.9%(1/53). Postoperative complications were associated with age, smoking history of the last 1 year, combined organ resection, lymph node dissection, intracorporeal anastomosis, and preoperative blood AST and Ca levels (all P<0.05). The results of multivariate analysis showed that intracorporeal anastomosis (OR=5.62, 95% CI: 2.46 to 12.85, P=0.00), preoperative blood AST (OR=-0.009, 95% CI: -0.018 to 0.000, P=0.04) and Ca (OR=0.51, 95% CI: 0.08 to 0.95, P=0.02) levels were independent prognosis factors affecting complications after right hemicolectomy.
Conclusions:Complications of right hemicolectomy were mainly Clavien-Dindo grade Ⅰ and Ⅱ. Laparoscopic intracorporeal anastomosis should be carefully chosen, which may increase postoperative complications.
