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Updated: Jul 15, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Oesophagectomy practice and outcomes in England.
A A Al-Sarira1, G David, S Willmott
1Leighton Research Unit, Department of Surgery, Leighton Hospital, Mid Cheshire NHS Trust, Crewe, UK.
Centralization of esophageal resections in England has increased, with more surgeries performed at high-volume hospitals. This trend correlates with a significant reduction in in-hospital mortality rates for esophageal cancer patients.
Area of Science:
- Oncology
- Surgical Outcomes
- Health Services Research
Background:
- UK National Health Service guidance in 2001 recommended centralization of esophageal resection to improve patient outcomes.
- Analysis of national trends in England was conducted to assess the occurrence and impact of centralization.
Purpose of the Study:
- To analyze national trends in esophageal resection in England.
- To determine if centralization of esophageal resection has occurred.
- To evaluate the impact of centralization on patient outcomes.
Main Methods:
- Utilized Hospital Episode Statistics data from 1997-1998 to 2003-2004.
- Included patients undergoing resection for esophageal cancer.
- Categorized annual hospital volumes based on recommended guidelines for designated centers.
Main Results:
- A total of 11,838 esophageal resections were analyzed.
- The number of hospitals performing resections decreased, with a notable drop in very low-volume hospitals.
- The proportion of resections in very high-volume hospitals increased (17.8% to 21.9%), alongside a significant reduction in overall in-hospital mortality (11.7% to 7.6%).
Conclusions:
- Centralization of esophageal resection and multidisciplinary team expertise contribute to improved mortality rates.
- Changes in preoperative patient selection also play a role in the observed reduction in mortality.
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