Oesophago-Gastric Surgical Quality Improvement Alliance (OG-SQILL) Multicentre national observational cohort study on variation in peri-operative care pathways following major oesophago-gastric resection Christopher Peters1, Tom Drake2, Chia Kong3, Krishna Moorthy1, and Olga Tucker4 on behalf of the Oesophago-Gastric Surgical Quality Improvement Alliance (OG-SQILL) 2Department of Surgery, Imperial College London 2Department of Clinical Surgery, University of Edinburgh 3Department of Medicine, University of Glasgow 4Department of Surgery, University of Birmingham Background Centralisation of oesophago-gastric (OG) cancer resections has led to substantial improvements in perioperative care with a reduction in post-operative mortality. However, morbidity rates remain high, with significant variation across UK centres in key outcomes. A multicentre prospective observational cohort study was performed to evaluate current practice and variation in peri-operative pathways of care. Methods 11 UK centres prospectively recorded patient demographics, operative details and peri-operative management for consecutive patients undergoing elective oesophago-gastric resections during a 3-month period. Figure 4: Median length of time intubated during and after oesophagectomy (extreme outliers not shown). Results p=0.06 Figure 5: Proportion of patients at each centre with a serious complication (Clavien-Dindo 3 or higher). Figure 1: Numbers of gastrectomies and oesophagectomies performed in each centre. p=<0.005 Figure 6: Median length of stay in days for patients following gastrectomies (extreme outliers not shown). Overall median 9 days (variation between centres 8-13). Figure 7: Median length of stay in days for patients following oesophagectomies (extreme outliers not shown). Overall median 14 days (variation between centres 7.5-44). Figure 2: Proportion of all cases performed at least in part laparoscopically. Conclusion Whilst outcomes following oesophago-gastric resection have improved in recent years this study has confirmed substantial variation in peri-operative care pathways. A national focus on standardisation of peri-operative care pathways and refinement of multidisciplinary care, with sharing of best practice, may further improve morbidity and mortality rates. Figure 3: Destination following oesophagectomy. Oesophago-Gastric Surgical Quality Improvement Alliance (OG-SQILL) Ravinder Vohra, Dmitri Nepogodlev & Olga Tucker, University Hospitals Birmingham Sacheen Kumar & Krishna Moorthy, St Mary’s Hospital, London Waleed Al Khyatt, Andrew Duncan, Sherif Awad, Syed Y Iftikhar & Paul Leader, Derby Hospitals NHS foundation trust Alex Harris, Mohamed Elshaer & Ahmed Al-Baharani, West Hertfordshire NHS Trust Caruana Clifford, Andrew Davies & James Gossage, St Thomas’s Hospital, London Tom Drake, University of Edinburgh Christopher Peters & Asif Chaudry, Royal Marsden NHS Foundation Trust Dariush Kamali & Y K S Viswanath, South Tees Hospitals NHS Foundation Trust Waduud Mohammed, Francesca Savioli & Matthew Forshaw, Glasgow Royal Infirmary Michelle Slater & Bruno Sgromo, Oxford University Hospitals NHS Foundation Trust Samantha Body & Stuart Mercer, Portsmouth Hospitals NHS Trust Max Almond & Oliver Priest, University Hospital of North Staffordshire Chia Kong, University of Glasgow 0161 P109