Short- and long-term complications of open radical prostatectomy according to the Clavien classification system.
OBJECTIVE
To assess the use of the Clavien classification system in documenting the complications related to open retropubic radical prostatectomy (RRP).


METHODS
The medical records of 995 patients, who had open RRP during a period of 7 years, were reviewed retrospectively. Short- and long-term complications were classified according to the recently revised Clavien classification system. We also compared the results with a recently reported series of laparoscopic and robotic RRP.


RESULTS
The overall complication rate was 26.9%; Grade I, Id, II, IIIa, IIIb and V complications were recorded in 3.4%, 3.9%, 12.8%, 2.6%, 3.8% and 0.3% of cases, respectively. Rectal injuries (10) and postoperative wound infections (24) were included in the Grade I category. Anastomotic leakage was recorded in 39 patients and rated as Grade Id. Grade II included cases of deep vein thrombosis (11), urinary tract infections (42), lymphorrhoeas (22) and haemorrhage requiring transfusion (53). Anastomotic strictures (26) and incisional hernias (38) were included in Grade IIIa and IIIb, respectively. Pulmonary embolism was fatal for three patients (0.3%) of Grade IV and V.


CONCLUSIONS
To avoid incoherence in reporting morbidity data, a reproducible and practical classification system is necessary. The Clavien system could provide, after refinement and validation, a common language among urologists.
Constantinides
Constantinos A
CA
1st University Department of Urology, Athens University Medical School, Laiko and Sismanoglio Hospital, Athens, Greece.
Tyritzis
Stavros I
SI
Skolarikos
Andreas
A
Liatsikos
Evangelos
E
Zervas
Anastasios
A
Deliveliotis
Charalambos
C
D000368:Aged; D006801:Humans; D010535:Laparoscopy / Q000145:classification*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics; D013997:Time Factors