Christina Y Koh, MD, Colette S Inaba, MD, Sarath Sujatha-Bhaskar, MD, Ninh Nguyen, MD. Univerisity of California, Irvine Medical Center
INTRODUCTION: The objective of this study is to examine the trends and outcomes of esophagectomy after implementation of ACS-NSQIP.
METHODS AND PROCEDURES: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database between 2008 and 2014 was used to obtain and analyze data for patients with esophageal cancer who underwent partial esophagectomy or total esophagectomy. Main outcome measures included 30-day mortality, serious morbidity, and length of stay. Outcomes were analyzed according to the first half of the study period (2008-2011) compared to the latter half (2012-2014).
RESULTS: From 2008 to 2014, 4,667 esophagectomies were performed for esophageal cancer, of which 2,130 were total esophagectomies and 2,537 were partial esophagectomies. The proportion of partial esophagectomies has risen from 33% in 2008 to 57% in 2014. Partial esophagectomy was the predominant operation after 2010. When comparing the first half of the study period (2008-2011) to the latter half of the study period (2012-2014) there was an overall reduction in average length of stay from 15.6 days to 13.3 days. However, there was no significant improvement in serious morbidity or 30-day mortality between the two time periods; 36.3% vs 35.4% (p=0.5476) for serious morbidity and 3.2% vs 2.3% (p=0.578) for 30-day mortality.
CONCLUSION: From 2008-2014, there was an increase in the proportion of partial esophagectomies performed for esophageal cancer. There has been an overall reduction in average length of stay; however no notable improvement in serious morbidity or mortality since ACS-NSQIP has been implemented. Further quality improvement initiatives should be implemented to reduce the morbidity and mortality associated with esophagectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80623
Program Number: P382
Presentation Session: Poster (Non CME)
Presentation Type: Poster
