Presented by: Mehmet Necmettin Mercimek Associate Professor
Atasam Hospital Urology Clinic, Samsun, TURKEY

Introduction

This study aims to compare the strength of the classical Clavien-Dindo classification system (CDCs), which is a Likert scale analysis versus the comprehensive complication index (CCI), a new quantitative evaluation system, in patients undergoing laparoscopic partial nephrectomy (LPN).

Materials

Prospectively collected data of sixty-two patients undergoing LPN with postoperative complications from November 2009 to August 2020 were evaluated retrospectively. Postoperative complications were classified according to the CDCs and calculated using CCI-calculator (https://www.assessurgery.com) quantitatively. Major complications were determined as ≥ grade 3 complications according to the CDCs. The complexity of the renal mass was defined according to the RENAL nephrometry score. The cut-off value for CCI was analyzed by ROC analysis technique. Significance level was taken as p<0.05.

Results

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The sensitivity and specificity were found at 21.43% and 91.11% according to the CDCs to integrate postoperative complications, respectively. However, the AUC (95% CI) value is 97.4% in differentiating major complications with a CCI cut-off value of 31.55 and above. Moreover, sensitivity was 86.67%, specificity was 97.87%, PPV value was 92.86%, NPV value was 95.83% and accuracy was 95.16%.

Conclusion

The study reveals that CCI has been found to evaluate both minor and major complications more accurately in patients undergoing LPN. Besides, it also has been shown that CDCs evaluate only minor complications more accurately.

Funding

none

Co-Authors

Mehmet Necmettin Mercimek, Associate Professor
Atasam Hospital Urology Clinic, Samsun, TURKEY

Ender Özden, Professor
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, TURKEY

Murat Gülşen, MD
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, TURKEY

Ertuğrul Köse, MD
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, TURKEY

Yakup Bostancı, Professor
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, TURKEY

Yarkın Kamil Yakupoğlu, Professor
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, TURKEY

Şaban Sarıkaya, Professor
Ondokuz Mayıs University, School of Medicine, Department of Urology, Samsun, TURKEY