Details der Publikation - International Variation in Surgical Practices in Units Performing Oesophagectomy for Oesophageal Cancer

International Variation in Surgical Practices in Units Performing Oesophagectomy for Oesophageal Cancer : A Unit Survey from the Oesophago-Gastric Anastomosis Audit (OGAA)

BACKGROUND: Anastomotic leaks are associated with significant risk of morbidity, mortality and treatment costs after oesophagectomy. The aim of this study was to evaluate international variation in unit-level clinical practice and resource availability for the prevention and management of anastomotic leak following oesophagectomy.

METHOD: The Oesophago-Gastric Anastomosis Audit (OGAA) is an international research collaboration focussed on improving the care and outcomes of patients undergoing oesophagectomy. Any unit performing oesophagectomy worldwide can register to participate in OGAA studies. An online unit survey was developed and disseminated to lead surgeons at each unit registered to participate in OGAA. High-income country (HIC) and low/middle-income country (LMIC) were defined according to the World Bank whilst unit volume were defined as < 20 versus 20-59 versus ≥60 cases/year in the unit.

RESULTS: Responses were received from 141 units, a 77% (141/182) response rate. Median annual oesophagectomy caseload was reported to be 26 (inter-quartile range 12-50). Only 48% (68/141) and 22% (31/141) of units had an Enhanced Recovery After Surgery (ERAS) program and ERAS nurse, respectively. HIC units had significantly higher rates of stapled anastomosis compared to LMIC units (66 vs 31%, p = 0.005). Routine post-operative contrast-swallow anastomotic assessment was performed in 52% (73/141) units. Stent placement and interventional radiology drainage for anastomotic leak management were more commonly available in HICs than LMICs (99 vs 59%, p < 0.001 and 99 vs 83%, p < 0.001).

CONCLUSIONS: This international survey highlighted variation in surgical technique and management of anastomotic leak based on case volume and country income level. Further research is needed to understand the impact of this variation on patient outcomes.

Medienart:	E-Artikel

Erscheinungsjahr:	2019
Erschienen:	2019

Enthalten in:	Zur Gesamtaufnahme - volume:43
Enthalten in:	World journal of surgery - 43(2019), 11 vom: 19. Nov., Seite 2874-2884

Sprache:	Englisch

Beteiligte Personen:	Oesophago-Gastric Anastomosis Study Group on behalf of the West Midlands Research Collaborative [VerfasserIn] Bundred, James R [Sonstige Person] Kamarajah, Sivesh K [Sonstige Person] Siaw-Acheampong, Kobby [Sonstige Person] Nepogodiev, Dmitri [Sonstige Person] Jefferies, Benjamin [Sonstige Person] Singh, Pritam [Sonstige Person] Evans, Richard [Sonstige Person] Griffiths, Ewen A [Sonstige Person] Alderson, Derek [Sonstige Person] Gossage, James [Sonstige Person] McKay, Siobhan [Sonstige Person] Mohamed, Imran [Sonstige Person] van Hillegersberg, Richard [Sonstige Person] Vohra, Ravinder [Sonstige Person] Wanigsooriya, Kasun [Sonstige Person] Whitehouse, Tony [Sonstige Person] Bagajevas, Aleksandras [Sonstige Person] Bekele, Abebe [Sonstige Person] Blanco-Colino, Ruth [Sonstige Person] Da Roit, Anna [Sonstige Person] El Kafsi-Mawley, Jihene [Sonstige Person] Gjata, Arben [Sonstige Person] Gockel, Ines [Sonstige Person] Castro, Raul Guevara [Sonstige Person] Harustiak, Tomas [Sonstige Person] Hsu, Po-Kuei [Sonstige Person] Isik, Arda [Sonstige Person] Kechagias, Aristotelis [Sonstige Person] Kennedy, Andrew [Sonstige Person] Kidane, Biniam [Sonstige Person] Mahendran, Hans Alexander [Sonstige Person] Mejia, Loreli [Sonstige Person] Moreno, Jorge Ignacio [Sonstige Person] Negoi, Ionut [Sonstige Person] Santiago, Azagra Juan [Sonstige Person] Sayyed, Raza [Sonstige Person] Schneider, Paul [Sonstige Person] Soares, António Sampaio [Sonstige Person] Sousa, Mariana [Sonstige Person] Takeda, Flavio Roberto [Sonstige Person] Vanstraten, Stephanie [Sonstige Person] Wallner, Bengt [Sonstige Person] Wijnhoven, Bas [Sonstige Person] Achiam, Michael [Sonstige Person] Agustin, Tita [Sonstige Person] Akbar, Ali [Sonstige Person] Al-Bahrani, Ahmad [Sonstige Person] Al-Khyatt, Waleed [Sonstige Person] Albertsmeier, Markus [Sonstige Person] Alghunaim, Essa [Sonstige Person] Alkhaffaf, Bilal [Sonstige Person] Allum, William [Sonstige Person] Am, Fernando [Sonstige Person] Andreollo, Nelson [Sonstige Person] Arndt, Andrew [Sonstige Person] Babor, Richard [Sonstige Person] Barbosa, Jose [Sonstige Person] Bardini, Romeo [Sonstige Person] Beardsmore, Duncan [Sonstige Person] Beban, Grant [Sonstige Person] Bernardes, Antonio [Sonstige Person] Berrisford, Richard [Sonstige Person] Bianchi, Alessandro [Sonstige Person] Bjelovic, Milos [Sonstige Person] Boddy, Alex [Sonstige Person] Bolca, Ciprian [Sonstige Person] Bonavina, Luigi [Sonstige Person] Bryce, Gavin [Sonstige Person] Byrom, Richard [Sonstige Person] Casaca, Rui [Sonstige Person] Chan, David [Sonstige Person] Charalabopoulos, Alexandros [Sonstige Person] Cheong, Edward [Sonstige Person] Ciotola, Franco [Sonstige Person] Colak, Elif [Sonstige Person] Collins, Chris [Sonstige Person] Constantinoiu, Silviu [Sonstige Person] Costa, Rita [Sonstige Person] Dahlke, Marc [Sonstige Person] Darling, Gail [Sonstige Person] Dawas, Kahled [Sonstige Person] de Manzoni, Giovanni [Sonstige Person] Denewer, Adel [Sonstige Person] Devadas, Michael [Sonstige Person] Dexter, Simon [Sonstige Person] Dikinis, Sarunas [Sonstige Person] Dimitrios, Theodorou [Sonstige Person] Dolan, James [Sonstige Person] Duong, Cuong [Sonstige Person] Egberts, Jan-Hendrik [Sonstige Person] Elgharably, Yasser [Sonstige Person] Elhadi, Muhammed [Sonstige Person] Elmahi, Seifeldin [Sonstige Person] Farias, Fernando Amézquita [Sonstige Person] Fekaj, Enver [Sonstige Person] Fernández, Jesus [Sonstige Person] Forshaw, Matthew [Sonstige Person] Freire, Jose [Sonstige Person] French, Daniel [Sonstige Person] Gacevski, Goran [Sonstige Person]

Links:	Volltext

Themen:	Journal Article Research Support, Non-U.S. Gov't

Anmerkungen:	Date Completed 01.07.2020 Date Revised 10.02.2024 published: Print Citation Status MEDLINE

doi:	10.1007/s00268-019-05080-1

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM299448355

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100	0		\|a Oesophago-Gastric Anastomosis Study Group on behalf of the West Midlands Research Collaborative \|e verfasserin \|4 aut
245	1	0	\|a International Variation in Surgical Practices in Units Performing Oesophagectomy for Oesophageal Cancer \|b A Unit Survey from the Oesophago-Gastric Anastomosis Audit (OGAA)
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520			\|a BACKGROUND: Anastomotic leaks are associated with significant risk of morbidity, mortality and treatment costs after oesophagectomy. The aim of this study was to evaluate international variation in unit-level clinical practice and resource availability for the prevention and management of anastomotic leak following oesophagectomy
520			\|a METHOD: The Oesophago-Gastric Anastomosis Audit (OGAA) is an international research collaboration focussed on improving the care and outcomes of patients undergoing oesophagectomy. Any unit performing oesophagectomy worldwide can register to participate in OGAA studies. An online unit survey was developed and disseminated to lead surgeons at each unit registered to participate in OGAA. High-income country (HIC) and low/middle-income country (LMIC) were defined according to the World Bank whilst unit volume were defined as < 20 versus 20-59 versus ≥60 cases/year in the unit
520			\|a RESULTS: Responses were received from 141 units, a 77% (141/182) response rate. Median annual oesophagectomy caseload was reported to be 26 (inter-quartile range 12-50). Only 48% (68/141) and 22% (31/141) of units had an Enhanced Recovery After Surgery (ERAS) program and ERAS nurse, respectively. HIC units had significantly higher rates of stapled anastomosis compared to LMIC units (66 vs 31%, p = 0.005). Routine post-operative contrast-swallow anastomotic assessment was performed in 52% (73/141) units. Stent placement and interventional radiology drainage for anastomotic leak management were more commonly available in HICs than LMICs (99 vs 59%, p < 0.001 and 99 vs 83%, p < 0.001)
520			\|a CONCLUSIONS: This international survey highlighted variation in surgical technique and management of anastomotic leak based on case volume and country income level. Further research is needed to understand the impact of this variation on patient outcomes
650		4	\|a Journal Article
650		4	\|a Research Support, Non-U.S. Gov't
700	1		\|a Bundred, James R \|e investigator \|4 oth
700	1		\|a Kamarajah, Sivesh K \|e investigator \|4 oth
700	1		\|a Siaw-Acheampong, Kobby \|e investigator \|4 oth
700	1		\|a Nepogodiev, Dmitri \|e investigator \|4 oth
700	1		\|a Jefferies, Benjamin \|e investigator \|4 oth
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700	1		\|a Evans, Richard \|e investigator \|4 oth
700	1		\|a Griffiths, Ewen A \|e investigator \|4 oth
700	1		\|a Alderson, Derek \|e investigator \|4 oth
700	1		\|a Gossage, James \|e investigator \|4 oth
700	1		\|a McKay, Siobhan \|e investigator \|4 oth
700	1		\|a Mohamed, Imran \|e investigator \|4 oth
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700	1		\|a Vohra, Ravinder \|e investigator \|4 oth
700	1		\|a Wanigsooriya, Kasun \|e investigator \|4 oth
700	1		\|a Whitehouse, Tony \|e investigator \|4 oth
700	1		\|a Bagajevas, Aleksandras \|e investigator \|4 oth
700	1		\|a Bekele, Abebe \|e investigator \|4 oth
700	1		\|a Blanco-Colino, Ruth \|e investigator \|4 oth
700	1		\|a Da Roit, Anna \|e investigator \|4 oth
700	1		\|a El Kafsi-Mawley, Jihene \|e investigator \|4 oth
700	1		\|a Gjata, Arben \|e investigator \|4 oth
700	1		\|a Gockel, Ines \|e investigator \|4 oth
700	1		\|a Castro, Raul Guevara \|e investigator \|4 oth
700	1		\|a Harustiak, Tomas \|e investigator \|4 oth
700	1		\|a Hsu, Po-Kuei \|e investigator \|4 oth
700	1		\|a Isik, Arda \|e investigator \|4 oth
700	1		\|a Kechagias, Aristotelis \|e investigator \|4 oth
700	1		\|a Kennedy, Andrew \|e investigator \|4 oth
700	1		\|a Kidane, Biniam \|e investigator \|4 oth
700	1		\|a Mahendran, Hans Alexander \|e investigator \|4 oth
700	1		\|a Mejia, Loreli \|e investigator \|4 oth
700	1		\|a Moreno, Jorge Ignacio \|e investigator \|4 oth
700	1		\|a Negoi, Ionut \|e investigator \|4 oth
700	1		\|a Santiago, Azagra Juan \|e investigator \|4 oth
700	1		\|a Sayyed, Raza \|e investigator \|4 oth
700	1		\|a Schneider, Paul \|e investigator \|4 oth
700	1		\|a Soares, António Sampaio \|e investigator \|4 oth
700	1		\|a Sousa, Mariana \|e investigator \|4 oth
700	1		\|a Takeda, Flavio Roberto \|e investigator \|4 oth
700	1		\|a Vanstraten, Stephanie \|e investigator \|4 oth
700	1		\|a Wallner, Bengt \|e investigator \|4 oth
700	1		\|a Wijnhoven, Bas \|e investigator \|4 oth
700	1		\|a Achiam, Michael \|e investigator \|4 oth
700	1		\|a Agustin, Tita \|e investigator \|4 oth
700	1		\|a Akbar, Ali \|e investigator \|4 oth
700	1		\|a Al-Bahrani, Ahmad \|e investigator \|4 oth
700	1		\|a Al-Khyatt, Waleed \|e investigator \|4 oth
700	1		\|a Albertsmeier, Markus \|e investigator \|4 oth
700	1		\|a Alghunaim, Essa \|e investigator \|4 oth
700	1		\|a Alkhaffaf, Bilal \|e investigator \|4 oth
700	1		\|a Allum, William \|e investigator \|4 oth
700	1		\|a Am, Fernando \|e investigator \|4 oth
700	1		\|a Andreollo, Nelson \|e investigator \|4 oth
700	1		\|a Arndt, Andrew \|e investigator \|4 oth
700	1		\|a Babor, Richard \|e investigator \|4 oth
700	1		\|a Barbosa, Jose \|e investigator \|4 oth
700	1		\|a Bardini, Romeo \|e investigator \|4 oth
700	1		\|a Beardsmore, Duncan \|e investigator \|4 oth
700	1		\|a Beban, Grant \|e investigator \|4 oth
700	1		\|a Bernardes, Antonio \|e investigator \|4 oth
700	1		\|a Berrisford, Richard \|e investigator \|4 oth
700	1		\|a Bianchi, Alessandro \|e investigator \|4 oth
700	1		\|a Bjelovic, Milos \|e investigator \|4 oth
700	1		\|a Boddy, Alex \|e investigator \|4 oth
700	1		\|a Bolca, Ciprian \|e investigator \|4 oth
700	1		\|a Bonavina, Luigi \|e investigator \|4 oth
700	1		\|a Bryce, Gavin \|e investigator \|4 oth
700	1		\|a Byrom, Richard \|e investigator \|4 oth
700	1		\|a Casaca, Rui \|e investigator \|4 oth
700	1		\|a Chan, David \|e investigator \|4 oth
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700	1		\|a Dahlke, Marc \|e investigator \|4 oth
700	1		\|a Darling, Gail \|e investigator \|4 oth
700	1		\|a Dawas, Kahled \|e investigator \|4 oth
700	1		\|a de Manzoni, Giovanni \|e investigator \|4 oth
700	1		\|a Denewer, Adel \|e investigator \|4 oth
700	1		\|a Devadas, Michael \|e investigator \|4 oth
700	1		\|a Dexter, Simon \|e investigator \|4 oth
700	1		\|a Dikinis, Sarunas \|e investigator \|4 oth
700	1		\|a Dimitrios, Theodorou \|e investigator \|4 oth
700	1		\|a Dolan, James \|e investigator \|4 oth
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700	1		\|a Egberts, Jan-Hendrik \|e investigator \|4 oth
700	1		\|a Elgharably, Yasser \|e investigator \|4 oth
700	1		\|a Elhadi, Muhammed \|e investigator \|4 oth
700	1		\|a Elmahi, Seifeldin \|e investigator \|4 oth
700	1		\|a Farias, Fernando Amézquita \|e investigator \|4 oth
700	1		\|a Fekaj, Enver \|e investigator \|4 oth
700	1		\|a Fernández, Jesus \|e investigator \|4 oth
700	1		\|a Forshaw, Matthew \|e investigator \|4 oth
700	1		\|a Freire, Jose \|e investigator \|4 oth
700	1		\|a French, Daniel \|e investigator \|4 oth
700	1		\|a Gacevski, Goran \|e investigator \|4 oth
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International Variation in Surgical Practices in Units Performing Oesophagectomy for Oesophageal Cancer : A Unit Survey from the Oesophago-Gastric Anastomosis Audit (OGAA)

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