Table 2 Definition of intraoperative complications according to ICARUS criteria
Intraoperative adverse events (iAEs) | Definition of the event | The grade of the iAEs | iAEs related to | No events | Preexisting medical conditions, atypical anatomical variants, and malfunctioning surgical instruments | iAEs recures conversion | Surgical step | The timing of iAE assessment | The management of iAEs | The clinical consequences of a given iAE in the postoperative course |
|---|---|---|---|---|---|---|---|---|---|---|
Bleeding requiring transfusion | External iliac artery injury | 3 | Surgery | 1 | No | No | Pelvic lymphadenectomy | At the time of operation | Suturing with 4.0 Prolene® by cardiovascular surgery | Drainage and hemogram monitoring |
External iliac vein injury | 3 | Surgery | 2 | No | No | Pelvic lymphadenectomy | at the time of operation | Suturing with 4.0 Prolene® by cardiovascular surgery | Drainage and hemogram monitoring | |
Bleeding superior vagina | 3 | Surgery | 1 | No | No | Hysterectomy | At the time of operation | Repair with 3.0 Vicryl® by obstetric surgeon | Drainage and hemogram monitoring | |
Bleeding during cystectomy | 1 | Surgery | 172 | No | No | Cystectomy | At the time of operation | Blood transfusion and bleeding control | Drainage and hemogram monitoring | |
Anemia without bleeding | Blood transfusion | 1 | Anesthesiology | 7 | Having preoperative anemia | No | Cystectomy | At the time of operation | Blood transfusion and hydration | The patient’s hemodynamic was followed |
Bowel injury | Rectal injury | 2 | Surgery | 3 | No | No | Prostatectomy | At the time of operation | Repair with 2.0 silk and Vicryl® by general surgeon | Delayed initiation of oral feeding |
3 | Surgery | 1 | Due to tumor invasion into the rectum | No | Prostatectomy | At the time of operation | The rectum was resected with a linear stapler. Colostomy was performed by GS | Delayed initiation of oral feeding | ||
Ileal anastomosis leak | 4b | Malfunctioning surgical instruments | 1 | Linear stapler | No | Ileal anastomosis | Post operation | The anastomosis leak was repaired by reoperation | NPO total parenteral nutrition was started | |
Appendix injury | 4a | Surgery | 1 | Intra-abdominal adhesions | No | Ileal anastomosis | At the time of operation | Appendectomy by general surgeon | No | |
Caecum injury | 2 | Surgery | 1 | No | No | During surgical exclusion | At the time of operation | Repair with 2.0 silk by general surgeon | Delayed initiation of oral regimen | |
Ileum injury | 4b | Malfunctioning surgical instruments | 1 | Cautery injury | No | Ileal anastomosis | At the time of operation | Side-to-side anastomosis by general surgeon | NPO total parenteral nutrition was started | |
Urinary organ injury | Bladder injury | 2 | Surgery | 2 | Tumor invasion into surrounding tissues | No | Bladder excision | At the time of operation | Bladder repair with 3.0 Vicryl® | Distilled water was added during the operation |
Ureter injury | 2 | Surgery | 1 | No | No | Ureter implantation | At the time of operation | Anastomosis was done again | Prolonged ureteral stent | |
Urethral fragmentation | 2 | Surgery | 1 | No | No | Urethrectomy | At the time of operation | Total urethrectomy | ||
Nerve injury | Obturatory nerve damage | 2 | Surgery | 1 | No | No | Prostatectomy | At the time of operation | Obturatory nerve repair with 6.0 Vicryl® | Lower extremity adduction movement limitation |
Overall | 196 | |||||||||