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322 Chapter 16 TABLE 3. Surgical complications according to Clavien-Dindo Classification Grade of surgical complication a n Grade I Pain at stoma Leakage of stoma High output stoma Re-feeding syndrome Ileus Prolapse of stoma 22 10 2 1 1 1 Grade II Diversion colitis Infection 1 1 Grade III-a Grade III-b ACNES Ileus Infection Retraction of stoma Stoma stenosis Relocation of stoma Stoma leakage Prolapse of stoma Parastomal wound problems Necrotic tissue removal Stomal perforation Parastomal abscess Volvulus Anastomotic leakage n/a 9 7 6 5 5 3 2 2 2 1 1 1 1 1 Grade IV n/a Grade V n/a Complications were counted again if they re-occurred after (surgical) treatment. n/a: not applicable, complications did not occur; ACNES, abdominal cutaneous nerve entrapment syndrome. a 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, and 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: Requiring surgical, endoscopic or radiological intervention, a) intervention not under general anesthesia, b) intervention under general anesthesia. Grade IV: Life-threatening complication (including CNS complications) requiring IC/ICU-management. Grade V: Death of a patient. 19 Complications Surgical complications were graded according to the Clavien-Dindo classification 19 and are shown in Table 3. Grade III complications occurred most often (46 times, 27 patients); the majority of these complications were caused by stoma problems. Grade I and Grade II complications occurred respectively twice (two patients) and 37 times (20 patients). Stoma problems occurred in 30 patients (81%), with revisions of the stoma in 12 patients (32%).