Objectives Complications are an inherent part of surgical procedures, more so in onco-surgeries given the radicality of the procedures. Negative outcomes must be audited and classified to find more specific targets for quality improvement. Our primary objective was to study the complications of gynecological onco-surgeries graded according to the Clavien-Dindo grading system. The secondary objective was to evaluate the association between perioperative risk factors and complications of gynecological onco-surgeries.

Methods A cohort of 157 patients who underwent onco-surgeries in a tertiary care center in South India was studied from August 2017 to May 2019. Patients diagnosed with benign lesions by histopathology post-operatively and patients who are not willing to participate in the study were excluded. Post-operative complications were noted and graded according to the Clavien-Dindo grading system.

Results Among a cohort of 157 patients who underwent gynecological onco-surgeries, a complication rate of around 41.1% is observed. Majority of these complications were grade 1 (n=43, 27.3%), grade 2 (n=34, 21.6%) or grade 3A (n=27, 17.2%). Severe complications, i.e.,>Grade 3b, were observed in around 8.2% of the study patients. Vulvar cancer patients had the highest complication rate of around 80% (all grade 3B complications). Among the intra-operative characteristics, only the complexity of the surgery showed statistical association with postoperative complications (p=0.04).

Conclusions Higher grade of complications according to the Clavien-Dindo grading system was significantly associated with duration of hospital stay.