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根据克利夫兰-唐恩分类法评估减重手术后的围手术期并发症。评分验证、文献回顾和单中心系列研究结果。

Perioperative complications following bariatric surgery according to the clavien-dindo classification. Score validation, literature review and results in a single-centre series.

机构信息

Department of Surgery, University Hospital "Jose María Morales Meseguer," at Murcia, Murcia, Spain.

Department of Surgery, University Hospital "Jose María Morales Meseguer," at Murcia, Murcia, Spain.

出版信息

Surg Obes Relat Dis. 2017 Sep;13(9):1555-1561. doi: 10.1016/j.soard.2017.04.018. Epub 2017 Apr 26.

Abstract

BACKGROUND

There is no unified system for reporting surgical complications after bariatric surgery. One increasingly used system for notifying postoperative complications is the Clavien-Dindo classification, which focuses on their therapeutic implications.

OBJECTIVE

The aim of this study is to validate and apply the Clavien-Dindo scale to a series of cases of bariatric surgery and systematically review its use worldwide.

SETTING

University hospital.

METHODS

A cohort of 321 patients with morbid obesity (Mean BMI: 45.4±5.5 kg/m) underwent surgery by the same team of surgeons, fundamentally using a laparoscopic gastric bypass. Initially, the Clavien-Dindo scale was translated and validated for its acceptability and reproducibility using the Kappa index. The scale was then applied to the whole of the bariatric series. A systematic review was also conducted in the literature regarding the use of the Clavien-Dindo classification after bariatric surgery. Lastly, a comparison was made with our results.

RESULTS

The classification was validated without any difficulty. Most of the postoperative complications are grades I (8.4%) and III (7.8%). We found it used in 15 series (including our own), which accounts for 10,347 patients. The overall results are analogous to our series.

CONCLUSIONS

The Clavien-Dindo scale has been validated and translated into Spanish. Application is quick and simple and enables comparisons to be made between centers and series. Our results are similar to those reported by other authors.

摘要

背景

目前尚无针对减重手术后外科并发症报告的统一系统。一种越来越多地用于通知术后并发症的系统是 Clavien-Dindo 分类,该系统侧重于并发症的治疗意义。

目的

本研究旨在验证和应用 Clavien-Dindo 量表对一系列减重手术病例,并对其在全球范围内的应用进行系统回顾。

设置

大学医院。

方法

一组 321 例病态肥胖患者(平均 BMI:45.4±5.5 kg/m)由同一组外科医生进行手术,主要采用腹腔镜胃旁路术。最初,使用 Kappa 指数对 Clavien-Dindo 量表进行翻译和验证,以评估其可接受性和可重复性。然后将该量表应用于整个减重系列。还对文献中使用 Clavien-Dindo 分类后的减重手术进行了系统回顾。最后,将我们的结果与其他研究进行了比较。

结果

分类没有任何困难地得到了验证。大多数术后并发症为 I 级(8.4%)和 III 级(7.8%)。我们发现该分类已在 15 个系列(包括我们自己的系列)中使用,涉及 10347 例患者。总体结果与我们的系列相似。

结论

Clavien-Dindo 量表已经得到验证和翻译成西班牙语。应用快速简单,并能够对不同中心和系列进行比较。我们的结果与其他作者的报告相似。

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