NSSG OG AUDIT DAY 2012 South Tees Hospitals Foundation Trust Sam Dresner, Consultant Surgeon Helen Wescott, OG Cancer CNS.

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Presentation transcript:

NSSG OG AUDIT DAY 2012 South Tees Hospitals Foundation Trust Sam Dresner, Consultant Surgeon Helen Wescott, OG Cancer CNS

MDT Workload New patients discussed Jan - Dec 2011 – 474 New patients discussed Jan – Dec 2010 – 493

Upper GI New Patients OG Oesophagus OG199 Stomach11493 Small Bowel52 GIST10 Total285258

HPB New Cases HPB Pancreas5762 Bile duct2332 Liver1114 Total93118

New cases - other Other Unknown2322 Not UGI Cancer2124 Not Cancer6152 Total11598

Number of MDT discussions

Patients By Referral Unit

Histological Subtype Oesophagus Cell Type Adenocarcinoma8581 Carcinoma52 HGD94 Squamous cell carcinoma 4243 Small Cell1 Not known11 NET12

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

OG Resection Audit Elective / emergency OG resection JCUH 01/01/10 – 01/01/ – 81 patients 2011 – 104 patients Median age 65 (31-82), M:F 80:24

Procedures 104 cases 3 cases benign – TG for AUGIB – 2x STG peptic ulcer disease LAGB complication 6 EMR

Procedures ProcedureSMDPADYKSV Open oesophagectomy Minimally invasive oesophagectomy Oesophagectomy with colonic interposition Oesophagectomy and lung resection Oesophageal EMR Inoperable oesophagectomy Gastric EMR Open total gastrectomy Laparoscopic total gastrectomy Open subtotal gastrectomy Laparoscopic subtotal gastrectomy Laparoscopic gastric wedge excision Laparoscopic assisted gastrectomy Laparoscopic gastric bypass Open gastric bypass Total

Outcome Median post-operative stay 12 days (1-90) Level 3 critical care 7/95 (7.3%) Anastomotic leak 3/95 (3.2%) Re-operation 1/95 (1%) 30-day mortality 1/95 (1%) – PE day 2 after oesophagectomy for T2N1MO ACA oesophagus 90-day mortality 3/95 (3.2%) – MI day 42 after total gastrectomy T1N0MO ACA stomach – Pneumonia / MOF day 49 after inoperable T4 ACA oesophagus

Summary 95 OG cancer surgical resections 6 EMR Inoperability – 4.2% (4/95) 2011 – 14% (11/78) day mortality 1%