title: Assessment of Clavien-Dindo classification in patients >75 years undergoing nephrectomy/nephroureterectomy.
abstract: BACKGROUND
  There is a paucity of a standardized post-operative complications grading system in urology especially in the elderly population. Studies show satisfactory survival and oncological outcomes albeit with a slight increase in post-operative morbidity compared to younger patients. The Clavien-Dindo classification for post-operative complications is established as a valid system worldwide and applicable in many fields of surgery.
  
  
  OBJECTIVE
  Retrospective assessment of post-operative complications in patients >75 years who underwent open/laparoscopic nephrectomy/nephroureterectomy for renal diseases and grading the post-operative complications according to the Clavien-Dindo classification.
  
  
  METHODS
  Retrospective review of case notes was performed in patients >75 years who underwent a laparoscopic/open nephrectomy/nephroureterectomy between 2000 and 2008. Post-operative complications were graded according to the Clavien-Dindo classification.
  
  
  RESULTS
  A total of 54 patients >75 years underwent nephrectomy/nephroureterectomy. 29 patients had laparoscopy and 25 had open surgery. Fifty one patients had a malignancy and 3 had benign diseases. Grade I, II, IIIa, IIIb and IVa were 25.6%, 41.1%, 7.7%, 7.7% and 17.9% respectively. No significant difference was noted in the 2 groups.
  
  
  CONCLUSIONS
  We believe that in elderly patients, laparoscopic surgery can be offered safely without significantly increasing the surgical risks. The Clavien-Dindo classification is easy to use and effectively applied to categorize post-operative complications associated with nephrectomy/nephroureterectomy in elderly population. However, this system needs slight modification to incorporate intra-operative complications and large studies are needed to validate and standardize this classification for all urological procedures.
authors: Department of Urology, St James's University Hospital, Leeds, United Kingdom.
authors: Atif
authors: A
authors: Khan
authors: Victor
authors: V
authors: Palit
authors: Andy
authors: A
authors: Myatt
authors: Jon J
authors: JJ
authors: Cartledge
authors: Anthony J
authors: AJ
authors: Browning
authors: Adrian D
authors: AD
authors: Joyce
authors: Chandra Shekhar
authors: CS
authors: Biyani
keywords: Clavien-dindo; elderly; nephrectomy
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