JCOG 術後合併症規準（ 分類）

1 JCOG Clavien-Dindo JCOG Postoperative Complication Criteria according to Clavien-Dindo classification 2011 9 JCOG JCOG JCOG JCOG 2011 9 20 1 2013 4 11 JCOG Clavien-Dindo 2 JCOG Clavien-Dindo 2009 Common Terminology Criteria for Adverse Events CTCAE CTCAE AE term MedDRA Medical Dictionary for Regulatory Activities AE term grading 2004 Clavien-Dindo Daniel Dindo 1 2 Clavien-Dindo grading grading Clavien-Dindo AE term AE term grading JCOG 8 6 Clavien-Dindo JCOG Clavien-Dindo AE term grading JCOG JCOG JCOG JCOG JCOG Clavien-Dindo

2 Clavien-Dindo JCOG Clavien-Dindo 3 Grading JCOG Clavien-Dindo AE term Clavien-Dindo grading Grade I IVR Grade I Grade I Grade II Grade III Grade IIIa Grade IIIb IVR Grade IV Grade IVa Grade IVb IC/ICU * Grade V Suffix d -d disability grade * IC intermediate care ICU intensive care unit IVa-d IVa-d IVa-d IIIb-d S IIIb-d I-d JCOG Clavien-Dindo 4 Clavien-Dindo classification of surgical complications (D.)

3 Dindo, N. Demartines, Clavien. Ann Surg. 2004; 240: 205-13) Grade I : Any deviation from the normal postoperative course without the need for pharmacological treatment or surgical , endoscopic, and radiological interventions Allowed therapeutic regimens are: drugs as antiemetics, antipyretics, analgetics, diuretics, electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside Grade II : Requiring pharmacological treatment with drugs other than such allowed for grade I complications Blood transfusions and total parenteral nutrition are also included Grade III : Grade IIIa : Grade IIIb : Requiring surgical , endoscopic or radiological intervention Intervention not under general anesthesia Intervention under general anesthesia Grade IV : Grade Iva : Grade IVb : Life-threatening complication (including CNS complications )* requiring IC/ICU management Single organ dysfunction (including dialysis) Multiorgan dysfunction Grade V : Death of a patient Suffix d.

4 If the patient suffers from a complication at the time of discharge, the suffix d (for disability ) is added to the respective grade of complication. This label indicates the need for a follow-up to fully evaluate the complication. * Brain hemorrhage, ischemic stroke, subarachnoidal bleeding, but excluding transient ischemic attacks. CNS, central nervous system; IC, intermediate care; ICU, intensive care unit. JCOG Clavien-Dindo 5 JCOG JCOG 2005 6 JCOG 1998 NCI NCI-Common Toxicity Criteria NCI-CTC 1 1999 4 2 2001 12 NCI-CTC JCOG JCOG JCOG 2003 NCI-CTC CTCAE Common Terminology Criteria for Adverse Events NCI CTCAE JCOG CTCAE JCOG JCOG CTCAE JCOG CTCAE CTCAE CTCAE

5 Grade CTCAE Grade JCOG CTCAE Grade CTCAE JCOG JCOG JCOG JCOG Clavien-Dindo 6 1 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: 205-13 2 Clavien PA, Barkun J, de Oliveira ML et al. The Clavien-Dindo classification of surgical complications : five-year experience. Ann Surg 2009; 250: 187-96