Evaluation of complications in urooncologic surgeries and recommended criterias

Abstract

Purpose: Variations of clinical practice, rising costs regarding to constrained resources in most health care systems in recent years increased interest to evaluate the quality of surgery. Therefore, composing the approved criterias for reporting of surgical morbidity and outcomes is important in order to increase quality of patient care and determining the efficacy of surgical techniques.

New Findings: Undetermimined standarts of surgical complications hamper evaulatiing the surgical performance and quality. Reporting of surgical complications is important for determiming the grade of recommendations of new techniques in guidelines. However, randomized control trilas with high level of evidance is sparse in surgical literature and this limitation leads to be low grade of recommendations. In the literature, Five standardized system proposed for reporting and classification of surgical complications. The Clavien- Dindo system is widely used especially in general surgery and urology. However, this system is not appropriately used in one third of urological publications. There are several situations that affect the accurate and comprehensive reporting of the complications such as the discrepancy of opinions of different professions about complications, inconsistency of the severity of the complications reported by the physicians and the patients, the absence of the observer dependent reliability. Although the literature have shown that the quality of the studies in the field of urooncology were inadequate to evaluate the surgical techniques and outcomes, there is a slight progress in minimal invasive radical prostatectomy literature in recent years.

Conclusion: We consider that the European Association of Urology Guidelines Panel recommendations about reporting and grading complications in urologic surgery could contribute to maintain the standards which are currently inadequate.