National Board of Examinations Journal of Medical Sciences (Mar 2024)

A Study to Evaluate the Complications of Laparoscopic Renal and Adrenal Surgeries Using Modified Clavien-Dindo Classification

  • Anil Kumar Nallabothula,
  • Anirudh Suseel Nalumaru,
  • Harsha Vardhana Varma Mudunuri,
  • Ashish Kumar Jayant,
  • Anupam Bhargava

DOI
https://doi.org/10.61770/NBEJMS.2024.v02.i03.003
Journal volume & issue
Vol. Volume 2, no. 3
pp. 192 – 204

Abstract

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Background: Laparoscopic surgery has become a widely accepted approach for the treatment of renal and adrenal diseases. However, there is a need to assess the post-operative complications associated with these procedures using standardized classification systems. The modified Clavien-Dindo classification system offers a comprehensive framework for evaluating surgical outcomes and determining the severity of complications. Methods: This prospective study involved 106 patients who underwent laparoscopic renal and adrenal resective surgeries. Post-operative complications were recorded and graded according to the modified Clavien-Dindo classification system. The data collected were analysed to assess the incidence and severity of complications in relation to patient demographics, comorbidities, and surgical procedures. Results: Among the 106 patients, 16.03% experienced post-operative complications, with 13.20% classified as minor complications and 2.83% as major complications. The most common minor complications included delayed bowel movements and wound infection, while major complications included conversion to open surgery and the need for ventilator support or haemodialysis. No deaths were reported in the study. The association between complication rates and age, gender, ASA grade, side of pathology, comorbidities, and pathology/diagnosis was not statistically significant. However, higher grade complications tended to occur more frequently in elderly patients, males, and those with comorbidities. Conclusions: This study supports the effectiveness of laparoscopic surgery for renal and adrenal diseases, as evidenced by low complication rates. The modified Clavien-Dindo classification system proved valuable in assessing and categorizing post-operative complications, enabling a comprehensive evaluation of surgical outcomes. Implementation of this standardized classification system can contribute to improving patient safety and the overall quality of surgical care. Further research with larger sample sizes and longer follow-up periods is recommended to obtain more precise and comprehensive data on long-term morbidity and mortality associated with laparoscopic renal and adrenal resective surgeries.

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