A Prospective Observational Study- Assessment and Categorization of Urological Operative Complications as Per Clavien Dindo Classification in Our Institution

At present main methods of assessing quality of surgical results & audits are mortality and morbidity. In 1992 Pierre Alain Clavien proposed a therapy oriented classification of post-operative complication. This grading system is well accepted worldwide as it is simple, reliable and valid. Our objectives are to assess and categorize urological operative complications as per Clavien-Dindo classification and to assess complication rates in reference to age, body mass index, American society of Anesthesiology score and comorbidities ( Diabetes, Hypertension ) and laparoscopic versus endourological versus open procedures. We prospectively observed total 310 urological operations conducted in our institute, aged 13-80 yrs, 190 male(61.3%) 120 female (38.7%) ,open procedure(n 122),laparoscopic procedure (n 35), endourological procedure(n153). We have assessed and categorized operative complications as per Clavien Dindo classification by detailed history, clinical examination and relevant investigations as required and also influence of predictors like age, BMI, ASA score, comorbidities ( Diabetes &Hypertension) and laparoscopic versus open surgical procedures have been calculated. We observed total 64 complications(20.6%); gr I 62.5%, gr II 15.6%, gr III 12.5%, grIV 3.1%, grV 6.2%; and complications in laparoscopic (17%) and endourological procedure (17.6%)are significantly less than open(35%). Age, BMI and comorbidities (Diabetes and hypertension) have significant influence on complication rates. Most of the complications are gradeI. Laparoscopic and endourological procedures have fewer complications than open procedure. Age, BMI and comorbidities (Diabetes and hypertension) have great influence on complications.