Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer.
<h4>Background</h4>The frequency of postoperative complications is used as an indicator of surgical quality; however, comparison of outcomes is hampered by a lack of agreement on the definition of complications and their severity. A standard grading system for surgical complications is n...
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doaj-e5cca4febdf143ccb0a7bef9320566532021-03-04T10:24:34ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01149e022257010.1371/journal.pone.0222570Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer.Shimpei MiyamotoJunichi NakaoTakuya HigashinoSeiichi YoshimotoRyuichi HayashiMinoru Sakuraba<h4>Background</h4>The frequency of postoperative complications is used as an indicator of surgical quality; however, comparison of outcomes is hampered by a lack of agreement on the definition of complications and their severity. A standard grading system for surgical complications is necessary to improve the quality of clinical research and reporting in head and neck reconstruction.<h4>Methods</h4>The aim of this study was to compare postoperative morbidity after microvascular head and neck reconstruction between patients with versus without a history of prior radiation therapy (RT) by using the Clavien-Dindo classification. A group of 274 patients was divided into two cohorts based on the history of prior RT: the RT group included 79 patients and the non-RT group included 195 patients. Postoperative (30-day) complications were compared between the groups with a nonstandardized evaluation system and the Clavien-Dindo classification.<h4>Results</h4>The grades of complications according to the Clavien-Dindo classification were significantly higher in the RT group than in the non-RT group. The frequency of postoperative complications did not differ significantly between the groups according to the nonstandardized evaluation system.<h4>Conclusions</h4>The Clavien-Dindo classification could serve as a useful, highly objective tool for grading operative morbidity after microvascular head and neck reconstruction when comparing similar defects and methods of reconstruction. Widespread use of the Clavien-Dindo classification system would allow adequate comparisons of surgical outcomes among different surgeons, centers, and therapies.https://doi.org/10.1371/journal.pone.0222570 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shimpei Miyamoto Junichi Nakao Takuya Higashino Seiichi Yoshimoto Ryuichi Hayashi Minoru Sakuraba |
spellingShingle |
Shimpei Miyamoto Junichi Nakao Takuya Higashino Seiichi Yoshimoto Ryuichi Hayashi Minoru Sakuraba Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. PLoS ONE |
author_facet |
Shimpei Miyamoto Junichi Nakao Takuya Higashino Seiichi Yoshimoto Ryuichi Hayashi Minoru Sakuraba |
author_sort |
Shimpei Miyamoto |
title |
Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. |
title_short |
Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. |
title_full |
Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. |
title_fullStr |
Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. |
title_full_unstemmed |
Clavien-Dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. |
title_sort |
clavien-dindo classification for grading complications after total pharyngolaryngectomy and free jejunum transfer. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2019-01-01 |
description |
<h4>Background</h4>The frequency of postoperative complications is used as an indicator of surgical quality; however, comparison of outcomes is hampered by a lack of agreement on the definition of complications and their severity. A standard grading system for surgical complications is necessary to improve the quality of clinical research and reporting in head and neck reconstruction.<h4>Methods</h4>The aim of this study was to compare postoperative morbidity after microvascular head and neck reconstruction between patients with versus without a history of prior radiation therapy (RT) by using the Clavien-Dindo classification. A group of 274 patients was divided into two cohorts based on the history of prior RT: the RT group included 79 patients and the non-RT group included 195 patients. Postoperative (30-day) complications were compared between the groups with a nonstandardized evaluation system and the Clavien-Dindo classification.<h4>Results</h4>The grades of complications according to the Clavien-Dindo classification were significantly higher in the RT group than in the non-RT group. The frequency of postoperative complications did not differ significantly between the groups according to the nonstandardized evaluation system.<h4>Conclusions</h4>The Clavien-Dindo classification could serve as a useful, highly objective tool for grading operative morbidity after microvascular head and neck reconstruction when comparing similar defects and methods of reconstruction. Widespread use of the Clavien-Dindo classification system would allow adequate comparisons of surgical outcomes among different surgeons, centers, and therapies. |
url |
https://doi.org/10.1371/journal.pone.0222570 |
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