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Diagnostic criteria and risk assessment of complications after gastric cancer surgery in western countries / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery ; (12): 135-139, 2017.
Article in Chinese | WPRIM | ID: wpr-303900
ABSTRACT
Postoperative complications are important outcome measurements for surgical quality and safety control. However, the complication registration has always been problematic due to the lack of definition consensus and the other practical difficulties. This narrative review summarizes the data registry system for single institutional registry, national data registry, international multi-center trial registries in the western world, aiming to share the experience of complication classification and data registration. We interviewed Dr. Koh from Royal Prince Alfred Hospital in Australia for single institutional experience, Dr. van der Wielen and Dr. Desideriofor, from two international multi-center trial(STOMACH) and registry (IMIGASTRIC) respectively, and Prof. Dr. Wijnhoven from the Dutch Upper GI Audit(DUCA). The major questions include which complications are obligated to report in the respective registry, what are the definitions of those complications, who perform the registration, and how are the complications evaluated or classified. Four telephone conferences were initiated to discuss the above-mentioned topics. The DUCA and IMGASTRIC provided the definition of the major complications. The consent definition provided by DUCA was based on the LOW classification which came out after a four-year discussion and consensus meeting among international experts in the according field. However, none of the four registries asked for an obligatory standardization of the diagnostic criteria among the participating centers or surgeons. Instead, all the registries required a detailed recording of the diagnostic strategy and classification of the complications with the Clavien-Dindo scoring system. Most data were registered by surgeons or data managers during or immediately after the hospitalization. The investigators or an independent third party conducted the auditing of the data quality. Standardization of complication diagnosis among different centers is a difficult task, consuming much effort and time. On top of that, standardization of the complication registration is of critical and practical importance. We encourage all centers to register complications with the diagnostic criteria and following intervention. Based on this, the Clavien-Dindo classification can be properly justified, which has been widely accepted by most centers and should be routinely used as the standard evaluation system for postoperative complications in gastric tumor surgery.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Postoperative Complications / Reference Standards / Australia / Stomach Neoplasms / General Surgery / Digestive System Surgical Procedures / Registries / Epidemiology / Data Collection / Classification Type of study: Diagnostic study / Etiology study / Risk factors Limits: Humans Country/Region as subject: Europa / Oceania Language: Chinese Journal: Chinese Journal of Gastrointestinal Surgery Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Postoperative Complications / Reference Standards / Australia / Stomach Neoplasms / General Surgery / Digestive System Surgical Procedures / Registries / Epidemiology / Data Collection / Classification Type of study: Diagnostic study / Etiology study / Risk factors Limits: Humans Country/Region as subject: Europa / Oceania Language: Chinese Journal: Chinese Journal of Gastrointestinal Surgery Year: 2017 Type: Article