Association of intraoperative errors and adverse events with postoperative complications in fellowship of advanced laparoscopic and bariatric surgery

Abstract

Intraoperative errors and adverse events have been important metrics for the analysis of surgeon skills and postoperative outcomes; however, the classification and relationship between them has not been reviewed or integrated before in the same study group, even with two recently validated instruments available such as the Generic Error Rating Tool (GERT) and Class-Intra scales. Objective: To analyze the relationship of errors with intraoperative adverse events and postoperative complications Methods: Observational, longitudinal, prospective and analytical study. The GERT, ClassIntra and Clavien-Dindo scales were used for data classification. Descriptive, graphic and significance analysis were applied with comparison of proportions and percentage for 3 or more groups based on the Q-CoChrane method with 95% confidence and multivariate hierarchical analysis with 95% confidence. Results: 30 patients operated on by Advanced Laparoscopy and Bariatric Surgery fellows. 449 errors (30 non-technical and 385 technical). 92 events: 86 grade I (93.47%) and 6 grade II (6.52%). 16 postoperative complications in 11 patients (36.6%): 9 grade I (56.25%), 2 grade IIIA (12.5%), 5 grade IIIB (31.25%). At medium levels of GERT errors added to the appearance of adverse events, the possibility of complications increases. Conclusion: The association between intraoperative errors and adverse events with postoperative results was demonstrated.

Keywords: Advanced laparoscopy, Intraoperative adverse event, Intraoperative error, ClassIntra