Strong Correlation but Moderate Agreement: Comparison of Clavien-Dindo and Clavien-Madadi Classification Systems in Pediatric Percutaneous Nephrolithotomy.

Utility of the Modified Clavien-Dindo-Sink (mCDS) Grading System for Classifying Casting Complication Severity in Early Onset Scoliosis Patients.

The utility of the mCDS system for grading complications of EOS casting is assessed and it is hypothesized that, with modifications, it would be a valid system for assessing these complications.

Clavien-Dindo classification in spinal surgery: A narrative review

The standardized reporting of postoperative complications is essential for improving surgical quality and comparing outcomes. However, spinal surgery has historically lacked a universal system and has instead relied on ambiguous terms. This narrative review synthesizes the literature on the adaptation, validation, and application of the therapy-based Clavien-Dindo classification (CDC) and its modified versions in spinal surgery. It focuses on studies across various spinal procedures and patient populations. The evidence shows that adapted CDC systems demonstrate good to excellent inter- and intrarater reliability, particularly for severe complications. These systems also facilitate direct comparison of surgical techniques. Moreover, they reveal strong correlations between complication severity, prolonged hospital stay, and patient factors such as frailty. Nevertheless, key limitations include poor correlation with certain long-term patient-reported outcomes. The CDC cannot capture intraoperative events or the cumulative burden of multiple complications. Subjectivity also exists in grading milder events. Recent spine-specific modifications that improve neurologic deficit assessment have enhanced clinical relevance. Overall, the CDC provides a critical framework for standardizing complication reporting in spinal surgery. Optimal application requires awareness of its limitations. In complex scenarios, the CDC may be applied most effectively as a component within more comprehensive, spine-specific taxonomies that incorporate surgical complexity and structured neurological assessment. The CDC remains a vital tool for improving communication, benchmarking, and ultimately enhancing patient care.

A Modified Clavien-Dindo Framework and a Heatmap Analysis to Identify Predictors of Complications After Endoscopic Enucleation of the Prostate.

BACKGROUND Holmium laser enucleation of prostate (HoLEP) is a size-independent procedure for benign prostatic obstruction. However, the predictors of various complications are poorly defined in the literature. OBJECTIVE We propose a standardized framework for reporting postenucleation complications using a modified Clavien-Dindo (CD) classification. We aim to identify predictors of postoperative complications following HoLEP within this unified framework, integrating both patient- and procedure-related variables. METHODOLOGY We retrospectively analyzed a prospectively collected database of patients undergoing HoLEP. Complications were stratified according to a modified CD classification framework developed for HoLEP. Predictors were analyzed using multinomial regression, and a heatmap was generated to identify correlations among predictors. RESULTS A total of 855 patients were included in the study. The median prostate volume was 102 cc. Minor complications were seen in 513 patients (60%), most frequently transient incontinence (37.4%). Major complications occurred in 46 patients (5.4%), primarily bladder neck stenosis (2%) and urethral stricture (2%). Multivariate analysis showed that advancing age (odds ratio [OR] 1.03; p = 0.008), recurrent urinary retention (OR 1.60; p = 0.003), elevated body mass index (BMI) (OR 1.04; p = 0.017), Anticoagulation use (OR 1.44; p = 0.029) and longer operative duration (OR 1.004; p = 0.002) were independent predictors of minor complications. Major complications were associated with smaller prostates (OR 0.93, p = 0.016). Spearman's correlation showed that postoperative incontinence was correlated with advanced age (r = 0.090, p < 0.01), high BMI (r = 0.082, p < 0.05), and longer surgical duration (r = 0.119, p < 0.01). Prostate volume was negatively correlated with postoperative inability to void (r = -0.107, p < 0.01), bladder neck stenosis (r = -0.107, p < 0.01), and urethral stricture (r = -0.102, p < 0.01). Gross hematuria was correlated with anticoagulation use (r = 0.101, p < 0.01) and BMI (r = 0.114, p < 0.01), although neither factor predicted major complications. CONCLUSION We proposed a standardized framework for reporting complications following endoscopic enucleation of the prostate. Our study also identified predictors of post-HoLEP major and minor complications.

TPT 1.07 A Comparative Statistical Analysis of Postoperative Complications and Clavien–Dindo Severity in Robotic versus Laparoscopic Gastrointestinal Surgery

As robotic platforms become increasingly adopted across colorectal and general surgical pathways, it is essential to understand their effect on postoperative morbidity. The Clavien–Dindo (CD) classification provides a validated framework for comparing complication severity. This study analysed complication rates and CD profiles following robotic and laparoscopic gastrointestinal procedures at a UK tertiary centre. A retrospective-review of all robotic and laparoscopic procedures performed between 2024–2025 was undertaken. Procedures included colorectal resections, small-bowel operations, hernia repairs, adhesiolysis, and stoma surgery. Complications and their corresponding CD categories were extracted from postoperative documentation. Comparisons between approaches used:Chi-square or Fisher’s exact test for overall complication rates, depending on frequency.Ordinal logistic regression to compare CD severity (I–V).Mann–Whitney U tests for length of stay (LOS).Binary logistic regression for predictors of any complication. Complications occurred across both groups, including ileus, infection, bleeding, electrolyte imbalance, wound issues, and pulmonary events. CD I–II complications predominated in both cohorts. CD-III events requiring intervention—including returns to theatre or radiological drainage—were observed at similar proportions. CD-IV complications (e.g., sepsis requiring organ support) occurred infrequently in both groups. Readmissions were comparable, typically for ileus or postoperative infection. Statistical-testing demonstrated no-significant difference in overall complication rates, CD category distribution, or LOS between robotic and laparoscopic procedures (all p > 0.05). Robotic surgery did not demonstrate reduced postoperative-morbidity or CD-severity compared with laparoscopy. Complication severity appeared primarily driven by patient factors and case complexity. Larger, procedure-specific studies are warranted.

Machine learning-based prediction of Clavien-Dindo ≥ II complications after ureteroscopy.

Complications in abdominal surgery: Assessment, prediction and prevention