Textbook outcomes after oesophagectomy: a single-centre observational study

Area of Science:

• Surgical Quality Improvement
• Oncology
• Gastroenterology

Background:

• Textbook outcome is a quality tool for ideal perioperative and postoperative care.
• Its application in oesophagectomy in Australia was previously unknown.
• This study aimed to assess textbook outcomes post-oesophagectomy and associated factors.

Purpose of the Study:

• To evaluate the achievement rate of textbook outcome after oesophagectomy.
• To identify patient, tumour, and treatment characteristics associated with textbook outcome.
• To assess the impact of textbook outcome on oncological outcomes like recurrence and survival.

Main Methods:

• Retrospective observational study of 110 oesophagectomy patients (2010-2019).
• Defined textbook outcome by 10 criteria including R0 resection, no major complications, and no mortality within 90 days.
• Analyzed associations between patient, tumour, and treatment factors and textbook outcome achievement.

Main Results:

• Overall textbook outcome rate was 24%.
• Most achieved criteria: no 90-day mortality (96%) and R0 resection (89%).
• Least achieved criteria: no severe postoperative complications (58%) and hospital stay ≤21 days (61%).

Conclusions:

• Textbook outcome was achieved in 24% of patients, indicating clinical relevance.
• Severe complications and prolonged hospital stay were primary barriers to achieving textbook outcome.
• Findings guide improvements in perioperative care and utilization of textbook outcome for surgical and oncological care enhancement.