nssg og audit day 2013
DESCRIPTION
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 2012 -575 New patients discussed Jan - Dec 2011 -474. Upper GI New Patients. HPB New Cases. - PowerPoint PPT PresentationTRANSCRIPT
NSSG OG AUDIT DAY 2013NSSG OG AUDIT DAY 2013
South Tees Hospitals Foundation TrustSouth Tees Hospitals Foundation Trust
Sam Dresner, Consultant SurgeonSam Dresner, Consultant SurgeonHelen Wescott, OG Cancer CNS Helen Wescott, OG Cancer CNS
MDT Workload
• New patients discussed Jan – Dec 2012- 575
• New patients discussed Jan - Dec 2011- 474
Upper GI New PatientsOG 2011 2012
Oesophagus 144 177
OG 9 14
Stomach 93 84
GIST 10 13
Total 256 287
HPB New CasesHPB 2011 2012
Pancreas 62 85
Bile duct 32 34
Liver 14 22
Small bowel 2 7
Ampulla 1 4
Total 111 152
New cases - otherOther 2011 2012
Unknown 22 13
Not UGI Cancer 24 38
Not Cancer 52 84
Total 98 135
Number of MDT discussions
Patients By Referral Unit
Histological Subtype(oesophagus, juctional, stomach)
Oesophagus Cell Type
2011 2012
Adenocarcinoma 181 199
Carcinoma 2 12
HGD 4 8
Squamous cell carcinoma
43 38
Small Cell 1 1
Not known 11 10
NET 2 7
Treatment ModalityTumour Type Curative / Radical
Treatment 2011 2012 Non Curative 2011 2012
Oesophagus SurgeryNeoadjuvantChemo/radRadical Rad2nd opinionEMRRFA
102813
1
640172531
BSCStentBrachytherapyAPCPall chemoPall Radio
5212613
482213515
Total 2012 177
52 74 92 103
Stomach SurgeryNeoadjuvantEMR2nd opinionOther
2191
1
1615212
BSCPall chemoPall RadioSurgery(bypass)
481331
33941
Total 201283
32 36 62 47
GOJ NeoadjuvantChemo/rad
3 41
BSCPall chemoPall Radio
231
45
Total 2012 14
3 5 6 9
Small Bowel SurgeryHPB
2 1
Pall chemoBSC
24
Total 2012 7
3 2 4
GIST SurgeryEMR
4 8 W&WGlivecRTBSC
231
32
1
Total 14
4 8 6 6
OG Resection Audit
• Elective / emergency OG database JCUH
• 2011 - 104 patients• 2012 - 96 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
ProceduresProcedure SMD PAD YKSV
Open subtotal gastrectomyLaparoscopic subtotal gastrectomyLaparoscopic assisted subtotal gastrectomyOpen total gastrectomyOpen total gastrectomy + splenectomyExtended total gastrectomyLaparoscopic / VATS oesophagectomyLaparoscopic / VATS oesophagectomy + lung resectionOpen oesophagectomyOpen oesophagectomy and splenectomyOpen oesophagectomy + colonic resectionInoperable
Total
290412207020
29
5006000016004
31
305400611114
26
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 mortality 0%• 90-day mortality 0%• In-hospital mortality 0%
• LOS (1-74) Median 11 days