Comparing Complications of Esophagectomy and Pancreaticoduodenectomy and Potential Impact on Hospital Systems Utilizing the Accordion Severity Grading System

Low, Donald E.; Kuppusamy, MadhanKumar; Hashimoto, Yasushi; Traverso, L. William

doi:10.1007/s11605-010-1325-5

Cited by 19 publications

(7 citation statements)

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“…The Clavien-Dindo classification has been validated by multiple studies across several surgical subspecialties (4,13,19). Similar validation has been performed for the other major classifications in use (24,25). Initial validation has been performed for the proposed classification in the present study; however, additional studies are recommended before widespread use.…”

Section: Discussionmentioning

confidence: 81%

Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee

Khalilzadeh

Baerlocher

Shyn

et al. 2017

Journal of Vascular and Interventional Radiology

542

251

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Section: Discussionmentioning

confidence: 81%

Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee

Khalilzadeh

Baerlocher

Shyn

et al. 2017

Journal of Vascular and Interventional Radiology

542

251

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“…Complications have been directly associated with every other critical outcome parameter associated with the surgical treatment of esophageal cancer. The incidence of complications has been directly linked to operative mortality 7,9,10 , cancer recurrence 11,12 , cancer survival 10,13 , hospital length of stay 10,13-15 , readmissions [16][17][18] , hospital costs [19][20][21] , hospital profit margin 21 as well as health-related quality of life [22][23][24] . Generating an accurate reflection of contemporary morbidity and mortality is particularly important as the role of surgery in the treatment of a variety of stages of esophageal malignancy is undergoing continuous assessment.…”

Section: Discussionmentioning

confidence: 99%

Benchmarking Complications Associated with Esophagectomy

et al. 2019

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“…Major complications following esophageal cancer surgery are associated with increased operative mortality, 1–3 cancer recurrence, diminished long-term survival, 4–8 longer hospital stay, 8–10 more readmissions, 11–14 greater hospital costs, 15,16 and worse long-term health-related quality of life (HRQL) 17,18 . Mortality rates are best in high-volume centers, but 90-day mortality remains between 2.5% and 7%, and, even in a minimally invasive era, morbidity rates are high 3,19,20 …”

mentioning

confidence: 99%

Evaluation of International Contemporary Operative Outcomes and Management Trends Associated With Esophagectomy

Kuppusamy

Low

2020

Annals of Surgery

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Objective: This study aims to verify the utility of international online datasets to benchmark and monitor treatment and outcomes in major oncologic procedures. Background: The Esophageal Complication Consensus Group (ECCG) has standardized the reporting of complications after esophagectomy within the web-based Esodata.org database. This study will utilize the Esodata dataset to update contemporary outcomes and to monitor trends in practice in an era of rapid technical change.Methods: This observational study, based on a prospectively developed specific database, updates esophagectomy outcomes collected between 2015 and 2018. Evolution in patient and operative demographics, treatment, complications, and quality outcome measures were compared between patients undergoing surgery in 2015 to 2016 and 2017 to 2018. Results: Between 2015 and 2018, 6022 esophagectomies from 39 centers were entered into Esodata. Most patients were male (78.3%) with median age 63. Patients having minimally invasive esophagectomy constituted 3177 (52.8%), a chest anastomosis 3838 (63.7%), neoadjuvant chemoradiotherapy 2834 (48.7%), and R0 resections 5441 (93.5%). For quality measures, 30-and 90-day mortality was 2.0% and 4.5%, readmissions 9.7%, transfusions 12%, escalation in care 22.1%, and discharge home 89.4%. Trends in quality measures between 2015 and 2016 (2407 patients) and 2017 and 2018 (3318 patients) demonstrated significant (P < 0.05) improvements in readmissions 11.1% to 8.5%, blood transfusions 14.3% to 10.2%, and escalation in care from 24.5% to 20% A significantly (P < 0.05) reduced incidence in pneumonia (15.3%-12.8%) and renal failure (1.0%-0.4%) was observed. Anastomotic leak rates increased from 11.7% to 13.1%, whereas leaks requiring surgery decreased 3.3% and 3.0%, respectively. Conclusions: The Esodata database provides a valuable resource for assessing contemporary international outcomes. This study highlights an increased application of minimally invasive approaches, a high percentage of complications, improvements in pneumonia and key quality metrics, but with anastomotic leak rates still >10%.

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Comparing Complications of Esophagectomy and Pancreaticoduodenectomy and Potential Impact on Hospital Systems Utilizing the Accordion Severity Grading System

Cited by 19 publications

References 19 publications

Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee

Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee

Benchmarking Complications Associated with Esophagectomy

Evaluation of International Contemporary Operative Outcomes and Management Trends Associated With Esophagectomy

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