Global Journal of Surgery
ISSN (Print): 2379-8742 ISSN (Online): 2379-8750 Website: http://www.sciepub.com/journal/js Editor-in-chief: Baki Topal
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Global Journal of Surgery. 2017, 5(1), 1-5
DOI: 10.12691/js-5-1-1
Open AccessArticle

Post Transvesical Prostatectomy (TVP) Complications, Risk Assessment Using Clavien–Dindo System in Kassala Teaching Hospital, Kassala, Sudan

Abdel Latif K Elnaim1, Mohammed MA M Ibnouf2, Fathelrahman M Toum3 and Mamoun Magzoub4,

1HSD UKMMC, MRCSEd, Kassala Teaching Hospital, Sudan

2MRCSEd, Kassala Teaching Hospital, Sudan

3Department of Surgery, Kassala Teaching Hospital, Sudan

4Department of Parasitology, Faculty of Medical Laboratory Sciences, Elrazi University, Sudan

Pub. Date: February 14, 2017

Cite this paper:
Abdel Latif K Elnaim, Mohammed MA M Ibnouf, Fathelrahman M Toum and Mamoun Magzoub. Post Transvesical Prostatectomy (TVP) Complications, Risk Assessment Using Clavien–Dindo System in Kassala Teaching Hospital, Kassala, Sudan. Global Journal of Surgery. 2017; 5(1):1-5. doi: 10.12691/js-5-1-1

Abstract

Background: Open surgery is the main treatment option for Large Volume (LV) BPH. We preferentially used a standardized system; the Clavien-Dindo grading system that was highly recommended by the European Association of Urology in 2014. The aim of this study was to identify the type and rate the complications following TVP. Methods: A prospective descriptive analytical study done in Kassala Teaching Hospital (Eastern Sudan) in a General Surgery Unit from January 2013 through December 2015. All patients [188] with a clinical problem of Benign Prostatic Hyperplasia (BPH) have been involved. Designed questionnaire was synchronously filled from the hospital records. Variables were: Age, ASA, Co-morbidities, Size of the prostate, Complications of BOO, duration of Catheterization pre-op, Duration of surgery, Hospital stay, Duration of irrigation, Removal of the catheter, Removal of the drain, renal impairment, Surgeon, Blood loss, SSI, Fistulae. Results: One hundred and eighty eight patients were included in the study over two years. Mean age 69.4 ± 8.5 SD. All the patients had a prostate > 80 ml by US scan. The size of the prostate has been categorized to 80-100 (135 patients 71.8%), 101-200 (48 patients 25.5%), and 201-250 (6 patients 3.2%). Complication rates according to Clavien-Dindo were 99 (52.6%) no complications, 81 (43%) grade II, 3 (1.6%) grade Iva, and 5 (2.6%) with grade V. Conclusion: Most complications occur in our setting is consistent with the literature except the SSI (Surgical Site Infection) rate. The Clavien-Dindo classification system promises to be a good system for assessing complications following prostatectomy. As a recommendation patients tracing for long term follow up of late complications, absence of national registry for most of them was a determinant limitation of our study.

Keywords:
LV-BPH TVP Clavien-Dindo grading system Sudan

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  M. Emberton, M. Fordham and M. Harrison. The effect of prostatectomy on symptom severity and quality of life. The Journal of urology (1996); 155: 191-196.
 
[2]  Perez J, Montlleo Sanchez M, Arano Bertran P. The use of the IPSS questionnaire in surgical patients. International Prostatic Symptom Score. Actas Uro Esp (1995); 19(3): 227.
 
[3]  Protogerou V, Argyropoulos V, Patrozos K, Tekerlekis P, Kostakopoulos A. An alternative minimally invasive technique for large prostates (>80 mL): transvesical prostatectomy through a 3-cm incision. Urology (2010); 75: 184-186.
 
[4]  Zwergel U, Wullich B, Lindenmeir U, Rohde V, Zwergel T. Longterm results following transurethral resection of the prostate. Eur Urol. (1998); 33: 476-480.
 
[5]  Alivizatos G, Skolarikos A, Chalikopoulos D, et al. Transurethral photoselective vaporization versus transvesical open enucleation for prostatic adenomas >80 mL: 12-mo results of a randomized prospective study. Eur Urol (2008); 54: 427-437.
 
[6]  Anil Kumar Varshney. Holmium Laser Enucleation of Prostate (HoLEP): The Platinum Standard. JIMSA (2011) 24: 3.
 
[7]  Tubaro A, Carter S, Hind A, Vicentini C, Miano L. A prospective study of the safety and efficacy of supra-pubic-transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol. (2001); 166: 172-176.
 
[8]  Mearini E, Marzi M, Mearini L, Zucchi A, Porena M. Open prostatectomy in benign prostatic hyperplasia: 10-year experience in Italy. Eur Urol. (1998); 34: 480-485.
 
[9]  Serretta V, Morgia G, Fondacaro L, et al. Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: a contemporary series of 1800 interventions. Urology (2002); 60:623-627.
 
[10]  Bansal A, Sankhwar S, Goel A, Kumar M, Purkait B, Aeron R. Grading of complications of transurethral resection of bladder tumor using Clavien–Dindo classification system. Indian J Urol. [2016] 9]; 32: 232-7.
 
[11]  American Society of Anesthesiologists. ASA Physical Status Classification System Accessed. The Cleveland Clinic Foundation 2015.
 
[12]  Rosette J, Alivizatos G, Madersbacher S, et al. Guidelines on Benign Prostatic Hyperplasia. European Urology Association (2009): 35.
 
[13]  Jepsen JV, Bruskewitz RC. Recent developments in the surgical management of benign prostatic hyperplasia. Urology (1998); 51: 23-31.
 
[14]  Reich O, Gratzke C, Stief CG. Techniques and longterm results of surgical procedures for BPH. Eur Urol. (2006); 49: 970-8.
 
[15]  Ahlstrand C, Carlsson P, Jonsson B. An estimate of the life-time cost of surgical treatment of patients with benign prostatic hyperplasia in Sweden. Scand J Urol Nephrol. (1996); 30: 37-43.
 
[16]  Lukacs B. Management of symptomatic BPH in France: who is treated and how? Eur Urol. (1999); 36(3): 14-20.
 
[17]  Serretta V, Morgia G, Fondacaro L, et al. Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: a contemporary series of 1800 interventions. Urology. (2002); 60: 623-7.
 
[18]  Mozes B, Cohen YC, Olmer L, Shabtai E. Factors affecting change in quality of life after prostatectomy for benign prostatic hypertrophy: the impact of surgical techniques. J Urol. (1996); 155: 191-6.
 
[19]  Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery (1992); 111(5): 518-26.
 
[20]  Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg (2004); 240(2): 205.
 
[21]  Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: Five-year experience. Ann Surg (2009); 250(2):187-96.
 
[22]  Hill AG, P. Njoroge. Suprapubic Transvesical Prostatectomy in a Rural Kenyan Hospital. East African Medical J. (2002.) 79 (2): 65-7.
 
[23]  CK Oranusi, AME Nwofor, IO Oranusi. Complication rates of open transvesical prostatectomy according to the Clavien–Dindo classification system. Nigerian Journal of Clinical Practice. (2012); 15 (1): 34-7.
 
[24]  AUA guideline on management of benign prostatic hyperplasia. Chapter 1: Diagnosis and treatment recommendations. J Urol (2003); 170: 530-47.
 
[25]  Lund BL, Dingsor E. Benign obstructive prostatic enlargement. A comparison between the results of treatment by transurethral electro-resection and the results of open surgery. Scand J Urol Nephrol (1976); 10: 33-8.