Authors:

Abstract

Aim: To audit current oesophagectomy outcomes, with particular emphasis on anastomotic technique and anastomotic leaks, against the standards identified in current literature.

Patients: Patients undergoing oesophagectomy for oesophageal cancer with curative intent. Intervention/Comparator: This is a non interventional study and aims to identify the variation in practice and outcomes from hospitals internationally. Data will be collected on pre, intra and postoperative factors which may influence outcomes.

Outcome(s)/Audit Standard: As set forth by AUGIS Guidance for the provision of services for Upper GI Surgery (2016) 1 Anastomotic leak rate should be <10% 2 Major postoperative morbidity should be <20% 3 30 day mortality rate should be <5% 4 90 day mortality rate should be <10%.

Study design: A nine month multicentre prospective audit will be performed globally starting in early 2018 and coordinated by the Oesophagogastric Anastomosis Audit Group through the West Midlands Research Collaborative. This will include patients undergoing oesophagectomy over 6 months and encompassing a 90day follow up period.

A pilot data collection period will be initiated at University Hospitals Birmingham and 3 other hospitals in 2017. Data will be collected in a REDCap Database. Currently there is variation in practice for those undergoing oesophagectomy. Using a collaborative approach we seek to obtain a large data set from which we can analyse trends in practice that may be associated with an improved outcome.

We believe that analysis of high quality prospectively collected data of anastomotic technique and leak management will facilitate identification of best practice and pave the way to a randomised trial in this arena. Over 30 centres have already expressed an interest in taking part in the audit and we have yet to significantly advertise and disseminate our finalised protocol. We hope to collate potentially the largest prospective, multicentre dataset on oesophagectomy outcome to date.