NSSG OG AUDIT DAY 2013 South Tees Hospitals Foundation Trust Sam Dresner, Consultant Surgeon Helen Wescott, OG Cancer CNS.

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Presentation transcript:

NSSG OG AUDIT DAY 2013 South Tees Hospitals Foundation Trust Sam Dresner, Consultant Surgeon Helen Wescott, OG Cancer CNS

MDT Workload New patients discussed Jan – Dec New patients discussed Jan - Dec

Upper GI New Patients OG Oesophagus OG914 Stomach9384 GIST1013 Total256287

HPB New Cases HPB Pancreas6285 Bile duct3234 Liver1422 Small bowel27 Ampulla14 Total111152

New cases - other Other Unknown2213 Not UGI Cancer2438 Not Cancer5284 Total98135

Number of MDT discussions

Patients By Referral Unit

Histological Subtype (oesophagus, juctional, stomach) Oesophagus Cell Type Adenocarcinoma Carcinoma212 HGD48 Squamous cell carcinoma 4338 Small Cell11 Not known1110 NET27

Treatment Modality Tumour TypeCurative / Radical Treatment Non Curative OesophagusSurgery Neoadjuvant Chemo/rad Radical Rad 2 nd opinion EMR RFA BSC Stent Brachytherapy APC Pall chemo Pall Radio Total StomachSurgery Neoadjuvant EMR 2 nd opinion Other BSC Pall chemo Pall Radio Surgery(bypass) Total GOJNeoadjuvant Chemo/rad BSC Pall chemo Pall Radio Total Small BowelSurgery HPB 2 1 Pall chemo BSC 2 4 Total GISTSurgery EMR 48W&W Glivec RT BSC Total

OG Resection Audit Elective / emergency OG database JCUH patients patients M:F 65:31

Procedures 96 patients EMR n=5 Palliative bypass local hospital – metastatic gastric cancer (DMH) n=1 – metastatic pancreatic cancer (FHN) n=1 Emergency (perforation/obstruction) – palliative resection n=1 Small bowel resections n=2 86 elective OG cancer resections – 95 OG cancer resections 2011

Procedures ProcedureSMDPADYKSV Open subtotal gastrectomy Laparoscopic subtotal gastrectomy Laparoscopic assisted subtotal gastrectomy Open total gastrectomy Open total gastrectomy + splenectomy Extended total gastrectomy Laparoscopic / VATS oesophagectomy Laparoscopic / VATS oesophagectomy + lung resection Open oesophagectomy Open oesophagectomy and splenectomy Open oesophagectomy + colonic resection Inoperable Total

Outcomes Inoperability (8/86) 9.3% Re-operation (3/86)3.5% – Bleeding n=2, Perforation n=1 Leak rate (Oesophagectomy 3/37)8.1% 30-day mortality0% 90-day mortality0% In-hospital mortality0% LOS (1-74)Median 11 days