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[接触式输尿管碎石术并发症的CLAVIENDINDO分类改编版]

[An adaptation of the CLAVIENDINDO classification of complications for contact ureterolithot- ripsy].

作者信息

Mamedov E A, Dutov V V, Bazaev V V, Podoynicyn A A, Buymistr S Yu

机构信息

GBUZ Moscow district Moscow Regional Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia.

出版信息

Urologiia. 2019 Jul(3):84-88.

Abstract

AIM

to study an adaptability of the Clavien-Dindo classification of complications for contact ureterolithotripsy.

MATERIALS AND METHODS

A total of 506 patients with ureteric stones who were undergone 545 endoscopic interventions in the Urologic Department of "MONIKI" named after M.F. Vladimirsky were included in retrospective analysis.

RESULTS

Complications of grade 1, II, IIIa and IIIb were noted in 39 (7.1%), 24 (4.3%), 15 (2.8%) and 14 cases (2,6%), respectively. Among the complications of grade IVa, an acute pyelonephritis was complicated by the septic shock. The complication of grade IVb developed in 1 case (0.2%). There were no complications of Grade V. The Clavien-Dindo classification allows to grade only postoperative complications and attempts to adapt it for the assessment of intraoperative complications can lead to the distortion of study results.

CONCLUSION

The uncontrolled use of the Clavien-Dindo classification in all areas of surgery can lead to a decrease in its accuracy, thereby reducing its value as fairly universal tool. In our opinion, a further work aimed to the development of strict criteria for the different grades of complications of the Clavien-Dindo classifications is needed. We believe it is possible and necessary to develop a single tool for the assessment of complications of typical interventions within a single surgical area.

摘要

目的

研究Clavien-Dindo并发症分类法对接触式输尿管碎石术的适应性。

材料与方法

对以M.F.弗拉基米尔斯基命名的“MONIKI”泌尿外科接受545次内镜干预的506例输尿管结石患者进行回顾性分析。

结果

分别有39例(7.1%)、24例(4.3%)、15例(2.8%)和14例(2.6%)出现1级、2级、3a级和3b级并发症。在4a级并发症中,急性肾盂肾炎并发感染性休克。4b级并发症发生1例(0.2%)。无5级并发症。Clavien-Dindo分类法仅允许对术后并发症进行分级,试图将其用于评估术中并发症可能会导致研究结果失真。

结论

在所有手术领域不加控制地使用Clavien-Dindo分类法可能会导致其准确性下降,从而降低其作为相当通用工具的价值。我们认为,需要进一步开展工作,为Clavien-Dindo分类法的不同等级并发症制定严格标准。我们相信,开发一种用于评估单一手术领域典型干预并发症的单一工具是可能且必要的。

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