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Association Between Multidisciplinary Team Meetings and Short-Term Postoperative Outcomes in Gastrointestinal
Hengbin Zhao1, Bang Liu1, Mingze Wu1
1Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Abstract:
IntroductionMultidisciplinary team meetings (MTMs) integrate expertise from different specialties to support individualized treatment planning. However, their association with short-term postoperative outcomes in high-risk patients with gastrointestinal malignancies remains unclear. This study evaluated the implementation of preoperative MTM discussion and its association with postoperative outcomes in patients with gastric cancer (GC) or colorectal cancer (CRC) complicated by diabetes mellitus and/or coronary heart disease.MethodsThis single-center retrospective cohort study included consecutive patients with histologically confirmed gastric or colorectal adenocarcinoma and concomitant diabetes mellitus and/or coronary heart disease who underwent radical resection between January 2020 and January 2024. Patients were divided into MTM and no-MTM groups according to whether they received preoperative MTM discussion. The primary outcome was the severity of postoperative complications during the hospitalization, categorized as no complication, Clavien-Dindo grade I-II, or grade III or higher. Multivariable ordinal logistic regression was used to estimate the association between the absence of preoperative MTM discussion and increasing complication severity. The secondary outcome was the occurrence of any postoperative complication and was analyzed using binary logistic regression. Firth penalized logistic regression for major postoperative complications was performed as a sensitivity analysis.ResultsA total of 477 patients were included, with 191 in the MTM group and 286 in the no-MTM group. The no-MTM group had a higher overall postoperative complication rate than the MTM group (19.2% vs. 12.0%, p=0.039), whereas ICU admission and hospitalization costs were higher in the MTM group. Multivariable ordinal logistic regression showed that absence of preoperative MTM discussion, longer operative time per 30-minute increase, and preoperative hypoalbuminemia were independently associated with increasing postoperative complication severity. Secondary analyses yielded generally consistent findings.ConclusionsPreoperative MTM discussion was associated with a lower occurrence and lower severity of postoperative complications during the hospitalization among high-risk patients with GC or CRC.