• Leonie R van der Werf, Linde A D Busweiler, Johanna W van Sandick, Mark I van Berge Henegouwen, Wijnhoven Bas P L BPL Erasmus University Medical Center, Rotterdam, The Netherlands., and Dutch Upper GI Cancer Audit (DUCA) group.
• Erasmus University Medical Center, Rotterdam, The Netherlands.
• Ann. Surg. 2020 Jun 1; 271 (6): 1095-1101.

ObjectiveThis nation-wide population-based study aimed to report postoperative morbidity and mortality after esophagectomy and gastrectomy in the Netherlands according to the definitions of the Esophagectomy Complications Consensus Group (ECCG).BackgroundTo standardize international outcome reporting in esophageal surgery, the ECCG developed a standardized outcomes set.MethodsFor this national cohort study, all patients undergoing esophagectomy or gastrectomy for cancer between 2016 and 2017 were selected from the Dutch Upper gastrointestinal Cancer Audit. In a random sample of hospitals, data completeness and accuracy were validated by reabstraction of the data. The investigated outcomes in the present study were postoperative complications, major complications (Clavien-Dindo grade ≥III), and 30-day mortality, according to definitions of the ECCG.ResultsA total of 2545 patients from 22 hospitals were included. The completeness of the Dutch Upper gastrointestinal Cancer Audit was estimated at 99.8%. Data accuracy on different items was 94% to 100%. After esophagectomy, 1046 of 1617 patients (65%) had a postoperative complication including 468 patients (29%) with a major complication. Most common complications were pneumonia (21%), esophago-enteric leak from anastomosis, staple line or localized conduit necrosis (19%), and atrial dysrhythmia (15%). The 30-day mortality was 1.7%. After gastrectomy, 397 of 928 patients (42%) had a postoperative complication including 180 patients (19%) with a major complication. Most common complications were pneumonia (12%), esophago-enteric leak from anastomosis, staple line or localized conduit necrosis (9%), and acute delirium (5%). The 30-day mortality was 4.4%.ConclusionsReporting complications according to the ECCG platform is feasible in the Netherlands and facilitates international benchmarking.

24 keywords...

hide…