Centralisation of oesophageal cancer services: experiences and outcomes of the first year of implementation at a Belgian non-academic teachinghospital

Acta Chir Belg. 2023 Feb;123(1):31-35. doi: 10.1080/00015458.2021.1930460. Epub 2021 May 26.

Abstract

Introduction: Oesophageal surgery recently became centralised in Belgium. This study aims to evaluate surgical outcomes and service delivered one year after implementation of centralisation.

Patients and methods: All patients undergoing an oesophagectomy between the start of the centralisation; 1st of June 2019 and 31st of May 2020, were included from a prospectively maintained database.

Results: 53 patients (41 male, 12 female) underwent an oesophagectomy during the study period. Most oesophagectomies were performed through an open left thoracoabdominal approach (64.2%), 30.2% via a minimally invasive approach and hybrid approaches were carried out in 5.7% of patients. In this study population, the 30 day mortality rate was 0% and the 90 day mortality rate was 3.8%, equating to 2 deaths. The overall 30 day readmission rate was 7.5%. Clinically significant anastomotic leaks occurred in 4 patients, (7.5%). Pneumonia and atrial fibrillation were the most frequent complications, both having a prevalence of 32.1%. The median length of stay was 11 days (IQR 9.5-14.5).

Conclusion: The results from our centre are comparable to those from international registers which demonstrate that centralisation of complex cancer services can be safely implemented.

Keywords: centralisation; oesophageal cancer; oesophagectomy.

MeSH terms

  • Anastomotic Leak
  • Belgium / epidemiology
  • Esophageal Neoplasms* / surgery
  • Esophagectomy / methods
  • Female
  • Humans
  • Male
  • Retrospective Studies