Evaluation of Short-term Postoperative Complications According to the Clavien-Dindo Classification System in Thermocautery-assisted Circumcision Cases

Abstract

Objective:Circumcision is one of the most performed surgical procedures in the world. This study is a retrospective study on the short-term postoperative complications after a thermocautery-assisted circumcision on a series of patients according to the Clavien-Dindo classification system (CDCS).Materials and Methods:A total of 2.356 male thermocautery-assisted circumcision cases, performed by two urologists in a hospital, were examined retrospectively. The mean age, type of anesthesia, peri- and postoperative complications, durations of the procedures, mean number of sutures, cohesive bandage requirements, and mean recovery times were evaluated.Results:The age of the patients ranged from 1 to 32 years with the mean age being 8.33 years. While 1.943 patients (82.47%) were only locally anesthetized, the remaining 413 (17.53%) were sedated in addition to local anesthesia. The mean values of the operative time, suture count, total requirement of cohesive bandages, and recovery time were 5.19±1.38 min (range of 4-20), 5.71 (range of 4-12), 69 (2.92%), and 6 days (range of 4-25), respectively. The short-term postoperative complications of 1.573 patients who returned to the hospital for a physical examination after being discharged were edema (mild, moderate, and severe), bleeding (simple and hematoma-causing), and infection (mild, moderate, and serious). The postoperative complications were adapted to the CDCS as grade 1 (638 patients, 40.55%), grade 2 (12 patients, 0.76%), grade 3 (6 patients, 0.38%), grade 4 (0 patients, 0%), and grade 5 (0 patients, 0%). There was no statistically significant difference between the patients in terms of complications adapted to the CDCS who received local anesthesia and those who received sedation + local anesthesia (p>0.05). Additionally, there was no significant difference in the development of penile edema between the patients who were sutured with Vicryl Rapide and normal Vicryl (p>0.05).Conclusion:Our retrospective results indicate that thermocautery-assisted circumcision has a short operative time and is tolerable despite its short-term complications. Thermocautery-assisted circumcision may be a useful method in regions where circumcision is common.

Keywords

• circumcision
• clavien-dindo classification system
• complications
• edema
• thermocautery