К вопросу о классификации осложнений в нейрохирургии (обзор литературы)

Проблема хирургических осложнений широко обсуждается среди нейрохирургов. Несмотря на наличие большого количества исследований, имеется неопределенность как в терминологии, так и в классификации осложнений. В настоящее время в нейрохирургии используются различные шкалы осложнений – как общехирургические, так и специфичны е. В обзоре представлены основные современные классификации осложнений операций, обозначены подходы, лежащие в их основе, а также их преимущества и недостатки. Отдельно рассматриваются вопросы систематизации интраоперационных осложнений.

1. Усачев Д. Ю. Мониторинг послеоперационных осложнений в нейрохирургической клинике // Кремлевская медицина. Клин. вестн. 2020. № 1. С. 40–45.

2. Landriel Ibañez F. A., Hem S., Aler P. et al. A new classification of complications in neurosurgery World Neurosurg. 2011; 75(5-6):709–715. Doi: 10.1016/j.wneu.2010.11.010 3. Veen M. R., Lardenoye J. W., Kastelein G. W. et al. Recording and classification of complications in a surgical practice. Eur J Surg. 1999;165(5):421–424. Doi: 10.1080/110241599750006622.

3. Rampersaud Y. R., Moro E. R. P., Neary M. A. et al. Intraoperative adverse events and related postoperative complications in spine surgery: implications for enhancing patient safety founded on evidence-based protocols. Spine (Phila Pa 1976). 2006;31(1):1503–1510. Doi: 10.1097/01.brs.0000220652.39970.c2.

4. Sokol D. K., Wilson J. What is a surgical complication? World J Surg. 2008;32(6):942–944. Doi: 10.1007/s00268 008-9471-6.

5. Clavien P., Sanabria J., Strasberg S. Proposed classification of complication of surgery with examples of utility in cholecystectomy. Surgery. 1992;(111):518–526. PMID: 1598671.

6. Dindo D., Demartines N., Clavien P. A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of Surgery. 2004;240(2):205–213. PMID: 15273542.

7. Clavien P. A., Barkun J., de Oliveira M. L. et al. The Clavien – Dindo classification of surgical complications: five-year experience Ann Surg. 2009;250(2):187–196. Doi: 10.1097/SLA.0b013e3181b13ca2.

8. Yoon P. D., Chalasani V., Woo H. H. et al. Use of Clavien – Dindo classification in reporting and grading complications after urological surgical procedures: analysis of 2010 to 2012 J Urol. 2013;190(4):1271–1274. Doi: 10.1016/j.juro.2013.04.025.

9. Тимербулатов В. М., Тимербулатов Ш. В., Тимербулатов М. В. Классификация хирургических осложнений (с комментарием редколлегии) // Хирургия: Журн. им. Н. И. Пирогова. 2018. № 9. С. 62–67. Doi: 10.17116/hirurg ia2018090162.

10. Казарян А. М., Акопов А. Л., Росок Б. Российская редакция классификации осложнений в хирургии // Вестн. хир. им. И. И. Грекова. 2014. Т. 173, № 2. С. 86 91. Doi: 10.24884/0042-4625-2014-173-2-86-91

11. Mitropoulos D., Artibani W., Ch.Sh. Biyani et al.Valida tion of the Clavien-Dindo Grading System in Urology by the European Association of Urology Guidelines Ad Hoc Panel, Eur Urol Focus. 2018;4(4):608-613. Doi: 10.1016/j.euf.2017.02.014.

12. Slankamenac K., Graf R., Barkun J. et al. The compre hensive complication index: a novel continuous scale to measure surgical morbidity K. Slankamenac. Ann Surg. 2013;258(1):1–7. Doi: 10.1097/SLA.0b013e318296c732.

13. Clavien P. A., Vetter D., Staiger R. D. et al. The Com prehensive Complication Index (CCI®): Added Value and Clinical Perspectives 3 Years “Down the Line”. Ann Surg. 2017;265(6):1045–1050. Doi: 10.1097/SLA.0000000000002132.

14. Kim T. H., Suh Y. S., Huh Y. J. et al. The comprehensive complication index (CCI) is a more sensitive complication index than the conventional Clavien – Dindo classifica tion in radical gastric cancer surgery. Gastric Cancer. 2018;21(1):171–181. Doi: 10.1007/s10120-017-0728-3.

15. Drexler R., Ricklefs F. L., Pantel T. F. et al. The Com prehensive Complication Index (CCI) as a Measure of Postoperative Morbidity and Neurological Outcome after Elective Intracranial Surgery. J Neurol Surg A Cent Eur Neurosurg. 2022. Doi: 10.1055/a-1962-0636.

16. Sink E. L., Leunig M., Zaltz I. et al. Reliability of a compli cation classification system for orthopaedic surgery. Clin Orthop Relat Res. 2012;470(8):2220–2226. Doi: 10.1007/s11999-012-2343-2.

17. Sarnthein J., Staartjes V. E., Regli L. et al. Neurosur gery outcomes and complications in a monocentric 7-year patient registry. Brain Spine. 2022;19(2):100860. Doi: 10.1016/j.bas.2022.100860.

18. Sebök M., Blum P., Sarnthein J. et al Validation of the Clavien – Dindo grading system of complications for microsurgical treatment of unruptured intracrani al aneurysms. Neurosurg Focus. 2021;51(5):10. Doi: 10.3171/2021.8.focus20892.

19. Bucher B., Maldaner N., Regli L. et al. Standardized as sessment of outcome and complications in chronic sub dural hematoma: results from a large case series. Acta Neurochir (Wien). 2019;161(7):1297–1304. Doi: 10.1007/s00701-019-03884-7.

20. Bellut D., Burkhardt J.-K., Schultze D. et al. Validating a therapy-oriented complication grading system in lumbar spine surgery: a prospective population-based study. Sci Rep. 201718;7(1):11752. Doi: 10.1038/s41598-017-12038-7.

21. Kommers I., Ackermans L., Ardon H. et al. Between-hos pital variation in rates of complications and decline of patient performance after glioblastoma surgery in the dutch Quality Registry Neuro Surger. J. Neurooncol. 2021;152(2):289–298. Doi: 10.1007/s11060-021-03697-8.

22. Houkin K., Baba T., Minamida Y. et al. Quantitative analysis of adverse events in neurosurgery. Neurosur gery. 2009;65(3):587–594. Doi: 10.1227/01.

23. Gozal Y. M., Aktüre E., Ravindra V. M. et al. Defin ing a new neurosurgical complication classification: lessons learned from a monthly Morbidity and Mor tality conference. J Neurosurg. 2019;(18):1–5. Doi: 10.3171/2018.9.JNS181004.

24. Bartek J., Gulati S., Unsgård G. et al. Standardized re porting of adverse events after microvascular decom pression of cranial nerves; a population-based single-in stitution consecutive series. Acta Neurochir (Wien). 2016;158(9):1775–1781. Doi: 10.1007/s00701-016-2856-7.

25. Schiavolin S., Broggi M., Acerbi F. et al. The Impact of Neurosurgical Complications on Patients’ Health Status: A Comparison Between Different Grades of Complications. World Neurosurg. 2015;84(1):36–40. Doi: 10.1016/j.wneu.2015.02.008.

26. Ferroli P., Brock S., Leonardi M. et al. Complications in neurosurgery: application of Landriel Ibañez classification and preliminary considerations on 1000 cases. World Neurosurg. 2014;82(3-4):576–577. Doi: 10.1016/j.wneu.2014.03.036.

27. Jensdottir M., Beniaminov S., Jakola A. S. et al. Standardized reporting of adverse events and functional status from the first 5 years of awake surgery for gliomas: a population-based single-institution consecutive series. Acta Neurochir (Wien). 2022;164(8):1995–2008. Doi: 10.1007/s00701-022-05191-0.

28. Terrapon Al. P., Zattra C. M., Voglis S. et al. Adverse Events in Neurosurgery: The Novel Therapy-Disability Neurology Grade. Neurosurgery. 2021;89(2):236–245. Doi: 10.1093/neuros/nyab121.

29. Vecchio T. G., Corell A., Buvarp D. et al. Classification of Adverse Events Following Surgery in Patients With Diffuse Lower-Grade Gliomas. Front Oncol. 2021;(11):792–878. Doi: 10.3389/fonc.2021.792878.

30. Rosenthal R., Hoffmann H., Clavien P. A. et al. Definition and Classification of Intraoperative Complications (CLASSIC): Delphi Study and Pilot Evaluation. World J Surg. 2015;39(7):1663–1671. Doi: 10.1007/s00268-0153003-y.

31. Dell-Kuster S., Gomes N.V., Gawria L. et al. Prospective validation of classification of intraoperative adverse events (ClassIntra): international, multicentre cohort study. BMJ. 2020;(25)370:2917. Doi: 10.1136/bmj.m2917.

32. Rosenthal R., Hoffmann H., Dwan K. et al. Reporting of adverse events in surgical trials: critical appraisal of current practice. World J Surg. 2015;39(1):80–87. Doi: 10.1007/s00268-014-2776-8.

33. Горбунов Н. С., Народов А. А., Ерахтин Е. Е., Залевский А. А. Конституциональный подход в лечении больных с опухолями головного мозга // Сибир. мед. обозрение. 2013. № 3. С. 48–51.