title: Clavien classification of complications after 150 laparoscopic pyeloplasties.
abstract: OBJECTIVE
  To compare the complications of laparoscopic pyeloplasty observed in 3 periods of our learning curve using the Clavien classification.
  
  
  METHODS
  We reviewed and retrospectively analyzed the records of 150 cases of laparoscopic pyeloplasty performed for primary ureteropelvic junction obstruction at our center. All patients were divided into 3 groups according to the order of the case number (1-50, 51-100, 101-150) to compare the intergroup differences in the preoperative data and perioperative parameters. The postoperative complications were subdivided according to the 5-grade Clavien classification of surgical complications. The groups of patients with and without complications were compared with respect to age, degree of hydronephrosis, positive urine culture before surgery, concomitant nephrolithiasis, crossing vessel, and the type of operation performed (dismembered vs nondismembered).
  
  
  RESULTS
  The success rate was 90.5%. The mean follow-up was 53.7 months (range 5-103). Intraoperative complications occurred in 9 (6%) of 150 patients and postoperative complications in 27 (18%) of 150 patients. No statistically significant differences were seen between the incidence of intra- and postoperative complications among the compared groups. The only statistically significant difference among the groups with and without complications was the presence of a positive urine culture (19% vs 6%, respectively).
  
  
  CONCLUSIONS
  The most common complications were connected with stent obstruction, and they did not seem dependent on surgeon experience. Patients with a preoperative positive urine culture might have a greater risk of postoperative complications.
authors.affiliation: Department of Urology and Urological Oncology, University of Medicine, Wrocław, Poland. szydelko@urol.am.wroc.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Szydełko
authors.forename: Jarosław
authors.initials: J
authors.lastname: Kasprzak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Apoznański
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Tupikowski
authors.forename: Artur
authors.initials: A
authors.lastname: Pupka
authors.forename: Dariusz
authors.initials: D
authors.lastname: Janczak
authors.forename: Romuald
authors.initials: R
authors.lastname: Zdrojowy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000473:pathology; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000473:pathology; D011183:Postoperative Complications / Q000145:classification* / Q000175:diagnosis*; D012189:Retrospective Studies; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000009:adverse effects*; D014572:Urology / Q000379:methods