ArticleWorld journal of surgery2015
Definition and Classification of Intraoperative Complications (CLASSIC): Delphi Study and Pilot Evaluation.
Article in World journal of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 69 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Impact of Deep Versus Standard Muscle Relaxation on Intra-operative Safety During Laparoscopic Surgery: a Multicenter Strategy Study
Intra-Operative Complication Assessment and Reporting With Universal Standards: Surgeons, Anesthesiologists, and Nurses Survey
Who cites it
69 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The incidence and classification of intraoperative adverse events in urological surgery: a systematic review.World journal of urology · 2025Pooled it
- Short-term outcomes of minimally invasive retromuscular ventral hernia repair using an enhanced view totally extraperitoneal (eTEP) approach: systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2022Pooled it
- Adverse intraoperative events during surgical repair of ruptured cerebral aneurysms: a systematic review.Neurosurgical review · 2021Pooled it
- A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats.Veterinary surgery : VS · 2020Pooled it
- Adverse Events in the Operating Room: Definitions, Prevalence, and Characteristics. A Systematic Review.World journal of surgery · 2019Pooled it
- Preoperative visceral fat area predicts intraoperative adverse events during lymphadenectomy in laparoscopic gastrectomy for gastric cancer: a post hoc analysis.Surgical endoscopy · 2025Trial
- Perioperative Outcomes and Recovery After Robot-Assisted vs Open Radical Hysterectomy: A Secondary Analysis of the RACC Randomized Clinical Trial.JAMA surgery · 2026Article
- Comparison between a laparoscopic articulating needle driver with standard laparoscopic instrumentation for total laparoscopic gastropexy in dogs.Veterinary surgery : VS · 2026Article
- How safe is teaching of highly specialized rectal surgery? A propensity score-matched 10-year cohort study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Article
- Applying classification of intraoperative adverse events (ClassIntra) to robot-assisted radical prostatectomy to predict the risk of postoperative adverse events.World journal of urology · 2026Article
- Early-onset colorectal cancer in Argentina: a multicenter surgical analysis of incidence, stage, and metastatic patterns.Lancet regional health. Americas · 2026Article
- Perioperative outcomes of 65 dogs and 15 cats undergoing lung lobectomies with a hilar circumferential ligature.Veterinary surgery : VS · 2026Article
- Routine Ketorolac Use for Postoperative Pain Does Not Increase Bleeding Risk After Hysterectomy.Journal of clinical medicine · 2026Article
- Intraoperative complications during gastrectomy for gastric cancer - incidence, treatment, and effect on postoperative complications and survival in a population-based nationwide study.Langenbeck's archives of surgery · 2025Article
- [Oncological operation reports: minimum requirements, legal aspects and future developments].Chirurgie (Heidelberg, Germany) · 2025Review
- Combined posterior and left-sided superior mesenteric artery-first approach to the TRIANGLE operation for pancreatic cancer.Annals of hepato-biliary-pancreatic surgery · 2025Article
- From practice to perfection-complications and operative time learning curves in benign robotic-assisted laparoscopic hysterectomy.Journal of robotic surgery · 2025Article
- Protocol for implementation of intraoperative adverse event recording during WHO checklist sign-out.BMJ open quality · 2025Article
- Systematic recording and discussion of intraoperative adverse events using ClassIntra: results of a qualitative context analysis before implementation.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStandardized reporting of intraoperative adverse events is important to enhance transparency. To the best of our knowledge, there is no validated definition and classification of intraoperative complications.
methodsWe conducted a two-round Delphi study to develop a definition and classification of intraoperative complications. Experts were contacted by email and sent a link to the online questionnaire. In a pilot study, two independent raters applied the definition and classification in a sample of 60 surgical interventions of low, intermediate, and high complexity and evaluated practicability. Interrater agreement of the classification was determined (raw categorical agreement, weighted kappa, and intraclass correlation).
resultsIn the Delphi study, 40 of 52 experts (77 % return rate) from 14 countries took part in each round. The Delphi study resulted in a comprehensive definition of intraoperative complications as any deviation from the ideal intraoperative course occurring between skin incision and skin closure. The classification foresees four grades depending on the need for treatment (no need, grade I; need for treatment, grade II) and the severity of the complication (life-threatening/permanent disability, grade III; death, grade IV). The pilot study showed good practicability (6 on a 7-point scale) and a high raw agreement of 87 %, a weighted kappa of 0.83 [95 % confidence interval (CI) 0.73-0.94] and an intraclass correlation coefficient of 0.83 (95 % CI 0.73-0.90).
conclusionsWhile the Delphi process enabled to develop definitions and classification of intraoperative complications by severity, further research including a multicentre international full-scale validation needs to be conducted with the ultimate goal to contribute to standardized reporting in surgical practice and research.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.