STATEWIDE TRENDS EM ESOPHAGECTOMY APPROACH: DATA FROM A REGIONAL THORACIC QUALITY COLLABORATIVE
Recommended Citation
Reddy R, Mollberg N, Adams K, Popoff A, Lam G, Lall S, Lagisetty K. STATEWIDE TRENDS EM ESOPHAGECTOMY APPROACH: DATA FROM A REGIONAL THORACIC QUALITY COLLABORATIVE. Dis Esophagus 2023; 36:84-85.
Document Type
Conference Proceeding
Publication Date
8-30-2023
Publication Title
Dis Esophagus
Abstract
Background: Esophagectomy patients continue to have high morbidity and mortality. Regional quality collaboratives have been shown to improve care around cardiac surgery. Our statewide cardiac surgery collaborative (33 programs) created thoracic surgery collaborative 10 years ago, sharing data to improve care at all locations. There were 17 programs participating in sharing lung cancer surgery data, and 10 programs sharing esophageal cancer surgery data. We reviewed trends in esophagectomy approach and perioperative outcomes from the quality collaborative. Methods: Prospectively collected data from patients with loco-regional esophageal cancer who underwent esophagectomy between 2014 to 2022 were analyzed. We evaluated 3 separate 3-year cohorts. Pre-operative assessment, surgical approach lymph node harvest, post-operative outcomes, and length of stay (LOS) were analyzed using linear regression and chi squared tests. Results: Annual esophagectomy volume ranged from 114 to 14S cases per year. There was significant increase in use of preoperative CT scans (p = 0.02) and a trend towards higher use of endoscopic resection as part of the staging paradigm (p = NS). There was a notable shift towards more minimally invasive esophagectomy approaches (p < 0.0001) with robotic assisted minimally invasive esophagectomy being the most common in the recent cohort (Figure). Lymph node harvest trended towards higher yield over time, but was only significant with the open trans-thoracic approaches (p < 0.01). There were no significant differences noted in rates of positive margin or in length of stay. Conclusion: Regional quality collaboratives allow for tracking of esophageal cancer care at a broader level than single institutions. We noted increased use of minimally invasive techniques, specifically robotic assisted over the past decade with trends towards improved lymph node dissection. Despite the increase use of minimally invasive surgery, length of stay did not change.
Volume
36
First Page
84
Last Page
85
