Postoperative complications: definition and classification
https://doi.org/10.24884/0042-4625-2024-183-2-76-81
Abstract
The concept of «postoperative (surgical) complication» implies a new pathological condition caused by surgical intervention, arising during its implementation and within 30 days later, having a clinical manifestation and requiring correction of treatment tactics. Based on this definitional approach, the classification of negative events associated with the operation, taking into account the involvement of the anatomical and functional structures of the body (local, regional and systemic) is presented. Another ranked feature is the syndromic characteristic of manifestations, which involves ordering problems depending on the leading cause of their formation of central or peripheral origin, including infectious and inflammatory nature, disorders in the hemostatic system and other variable (different) situations. This approach allows to plan and implement measures for the prevention and treatment of complications in practice. The logic of the pathophysiological understanding of their symptoms facilitates the prediction and early diagnosis of perioperative incidents.
About the Author
A. B. Larichev
Yaroslavl State Medical University
Russian Federation
Competing Interests:
Russian Federation
Larichev Andrey B., Dr. of Sci. (Med.), Professor, Head of the Department of General Surgery
5, Revolutionary str., Yaroslavl, 150000
Competing Interests:
The author declares no conflict of interest
References
1. Sokol D. K., Wilson J. What is a surgical complication? World Journal of Surgery. 2008;32(6):942–944. DOI: 10.1007/s00268-008-9471-6.
2. Clavien P.A., Sanabria J. R., Strasberg S. M. Proposed classification of complications of surgery with examples of utility in cholecystectomy // Surgery. 1992;111(5):518–526. PMID: 1598671.
3. Veen M. R., Lardenoye J.-W. H. P., Kastelein G. W., Breslau P. J. Recording and Classification of Complications in a Surgical Practice // European Journal of Surgery. 1999;165:421–424. DOI: 10.1080/110241599750006622.
4. Dindo D., Demartines N., Clavien P. A. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of Surgery. 2004;240(2):205–213. DOI: 10.1097/01.sla.0000133083.54934.ae.
5. Li J., Moustafa M., Freiwald-Bibiza E. et al. Is it feasible to standardize a composite postoperative complication reporting system for liver resection? Journal of Gastrointestinal Surgery. 2020;24(12):2748–2755. DOI: 10.1007/s11605-019-04457-w.
6. Jung M. R., Park Y. K., Seon J. W. et al. Definition and classification of complications of gastrectomy for gastric cancer based on the accordion severity grading system. World Journal of Surgery. 2012;36(10):2400– 2411. DOI: 10.1007/s00268-012-1693-y.
7. Wigmore S. J., Garden O. J. Defining surgical complications. World Journal of Surgery. 2008;32(6):948. DOI: 10.1007/s00268-008-9553-5.
8. Wheeler M. H. What is a surgical complication? World Journal of Surgery. 2008;32(6):947. DOI: 10.1007/s00268-008-9518-8.
9. Gough I. What is a surgical complication? World Journal of Surgery. 2008;32(6):950–951. DOI: 10.1007/s00268-008-9544-6.
10. Agarwal G. Surgical complications. World Journal of Surgery. 2008;32(6):949. DOI: 10.1007/s00268-008-9517-9.
11. Goslings J. C., Gouma D. J. What is a surgical complication? World Journal of Surgery. 2008;32(6):952. DOI: 10.1007/s00268-008-9563-3.
12. Schein M. What is a surgical complication? World Journal of Surgery. 2008;32(6):945–946. DOI: 10.1007/s00268-008-9516-x.
13. Dindo D., Clavien P.-A. What is a surgical complication? World Journal of Surgery. 2008;32(6):939–941. DOI: 10.1007/s00268-008-9584-y.
14. Strasberg S. M., Linehan D. C., Hawkins W. G. The accordion severity grading system of surgical complications. Annals of Surgery. 2009;250(2):177–186. DOI: 10.1097/SLA.0b013e3181afde41.
15. Strasberg S., Hall B. Postoperative Morbidity index: a quantitative measure of severity of postoperative complications. Journal of the American College of Surgeons. 2011;213(5):616–626. DOI: 10.1016/j.jamcollsurg.2011.07.019.
16. Sitkowski M., Kenig J. Evaluation of postoperative complications in the older population. NOWOTWORY. Journal of Oncology. 2022;72(4):250– 257. DOI: 10.5603/NJO.2022.0039.
17. Slankamenac K., Graf R., Barkun J. et al. The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Annals of Surgery. 2013;258(1):1–7. DOI: 10.1097/SLA.0b013e318296c73.
18. Kazaryan A. M., Rosok B. I., Edwin B. Morbidity assessment in surgery: refinement proposal based on a concept of perioperative adverse events // International Scholarly Research Notices of Surgery. 2013; 16:625093. DOI: 10.1155/2013/625093.
19. Kazarian A. M., Akopov A. L., Rosok B. et al. Russian classification edition of complications in surgery. Grekov’s Bulletin of Surgery. 2014;173(2):86– 91. (In Russ.). DOI: 10.24884/0042-4625-2014-173-2-86-91.
20. Likhvantsev V. V., Skripkin Yu. V., Filippovskaya ZhS, Zhgulyov DA. Standardization of complications and outcomes of surgery treatment // Messenger of Anesthesiology and Resuscitation. 2015;12(4):53–66. (In Russ.). DOI: 10.21292/2078-5658-2015-12-4-53-66.
21. Timerbulatov V. M., Timerbulatov Sh. V., Timerbulatov M. V. Classification of surgical complications. Pirogov Russian Journal of Surgery. 2018; 9:62–66. (In Russ.). DOI: 10.17116/hirurgia201809162.
22. Manekk R. S., Gharde P., Gattani R., Lamture Y. Surgical complications and its grading: a literature review. Cureus. 2022;14(5):e24963. DOI: 10.7759/cureus.24963.
23. Leriche R. Fundamentals of physiological surgery: Essays on the vegetative life of tissues. Moscow, Medgiz, 1961. 292 p. (In Russ.).
24. Shulutko B. I. On the theory and practice of diagnosis and treatment strategy. Мedicine and Education. 2020;1(5):16–25. (In Russ.).
25. Zilber A. P. Clinical physiology in anesthesiology and resuscitation. Moscow, Medicine, 1984. 480 p. (In Russ.).
26. Larichev A. B. Postoperative complications in surgical practice. Yaroslavl, Avers-Plus, 2022. 60 p. (In Russ.).
27. Anichkin V. V., Sachek M. G., Martynyuk V. V. Postoperative complications in abdominal surgery. Saarbrucken, LAP LAMBERT Academic Publishing, 2014. 244 p. (In Russ.).
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For citations:
Larichev A.B. Postoperative complications: definition and classification. Grekov's Bulletin of Surgery. 2024;183(2):76-81. (In Russ.) https://doi.org/10.24884/0042-4625-2024-183-2-76-81
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