Classification of intraoperative adverse events

Any deviation from the ideal intraoperative course:

Without the need for any additional treatment or intervention

Patient with no or mild symptoms

Bleeding: bleeding above average from small-caliber vessel: self-limiting or definitively manageable without additional treatment than routine coagulation

 

Injury: minimal serosal intestinal lesion, not requiring any additional treatment

 

Cautery: small burn of the skin, no treatment necessary

 

Arrhythmia: arrhythmia (eg, extrasystoles) without relevance

Any deviation from the ideal intraoperative course:With the need for any additional minor treatment or intervention

Patient with moderate symptoms, not life-threatening and not leading to permanent disability

Bleeding: bleeding from medium-caliber artery or vein, ligation; use of tranexamic acid

 

Injury: nontransmural intestinal lesion requiring suture(s)

 

Cautery: moderate burn requiring noninvasive wound care

 

Arrhythmia: arrhythmia requiring administration of antiarrhythmic drug, no hemodynamic effect

Any deviation from the ideal intraoperative course:

With the need for any additional moderate treatment or intervention

Patient with severe symptoms, potentially life-threatening or potentially leading to permanent disability

Bleeding: bleeding from large-caliber artery or vein with transient hemodynamic instability, ligation, or suture; blood transfusion

 

Injury: transmural intestinal lesion requiring segmental resection

 

Cautery: severe burn requiring surgical debridement

 

Arrhythmia: arrhythmia requiring administration of antiarrhythmic drug, transient hemodynamic effect

Any deviation from the ideal intraoperative course:

With the need for any additional major and urgent treatment or intervention

Patient with life-threatening symptoms or leading to permanent disability

Bleeding: life-threatening bleeding with splenectomy; massive blood transfusion; ICU stay

 

Injury: injury of central artery or vein requiring extended intestinal resection

 

Cautery: life-threatening burn injury by cautery leading to fire requiring ICU treatment

 

Arrhythmia: arrhythmia requiring electroconversion, defibrillation, or admission to the ICU