235 Oesophageal Cancer Surgery Outcomes Following the Introduction of a Standardised Post Operative Pathway

Abstract Aim To evaluate the outcomes for patients undergoing oesophagectomy for oesophageal cancer following a quality improvement programme. Method Patients undergoing oesophagectomy for oesophageal cancer between 1st June 2013 and 1st February 2025 were included. Patients’ electronic health record was reviewed to collect demographic data, operative approach and mortality at 90 days post-surgery. In January 2019 a quality improvement approach was undertaken, and 4 bundles were introduced; standardisation of operative technique, intensive care unit stay post operatively, protocol driven post operative care and physiotherapy focussed rehabilitation. The cohorts were compared (using a Χ2 test) before and after January 2019 to assess any improvement in post operative mortality at 90 days. Results One-hundred and twenty-seven patients underwent oesophagectomy and were included in this study. The median age of all patients was 65 years (range 38-77 years) and 21 (16.5%) were female. Eight (6.3%) underwent a thoracoabdominal approach and the remaining (93.7%) patients underwent an Ivor Lewis oesophagectomy. Fifty patients underwent oesophagectomy between 1st June 2013 and 1st January 2019, and 77 patients underwent oesophagectomy between 2nd January 2019 and 1st February 2025. The 90-day mortality rate improved from 16% in the earlier cohort to 2.9% in the later cohort (p=0.0064). Conclusions There has been a statistically significant reduction in the 90-day mortality rate (16.0% vs 2.9%, p=0.0064) for patients undergoing oesophagectomy following the introduction of 4 quality improvement bundles. Further work should be undertaken to evaluate potential quality improvement bundles for other domains such long term morbidity and oncological outcomes.