ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2014
Evolution of standardized clinical pathways: refining multidisciplinary care and process to improve outcomes of the surgical treatment of esophageal cancer.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Quality Performance Indicators for the Surgical Management of Oesophageal Cancer: A Systematic Literature Review.World journal of surgery · 2023Pooled it
- Lessons learned from 150 total gastrectomies for prevention of cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2025Article
- ERAS guidelines-driven upper gastrointestinal contrast study after esophagectomy can detect delayed gastric conduit emptying and improve outcomes.Surgical endoscopy · 2023Article
- Analysis of Compliance with Enhanced Recovery After Surgery (ERAS) Protocol for Esophagectomy.World journal of surgery · 2022Article
- ERAS guidelines-driven upper gastrointestinal contrast study after esophagectomy.Surgical endoscopy · 2022Article
- Length of hospital stay after uncomplicated esophagectomy. Hospital variation shows room for nationwide improvement.Surgical endoscopy · 2021Article
- Nutritional jejunostomy in esophagectomy for cancer, a national register-based cohort study of associations with postoperative outcomes and survival.Langenbeck's archives of surgery · 2021Article
- Safety and feasibility of minimally invasive surgical interventions for esophageal and gastric cancer in the acute setting: a nationwide cohort study.Surgical endoscopy · 2021Article
- Reorganizing the Multidisciplinary Team Meetings in a Tertiary Centre for Gastro-Intestinal Oncology Adds Value to the Internal and Regional Care Pathways. A Mixed Method Evaluation.International journal of integrated care · 2021Article
- [Perioperative enhanced recovery after surgery program for Ivor Lewis esophagectomy : First experiences of a high-volume center].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021Observational
- Paravertebral catheter versus EPidural analgesia in Minimally invasive Esophageal resectioN: a randomized controlled multicenter trial (PEPMEN trial).BMC cancer · 2020Article
- The evolution of fast track protocols after oesophagectomy.Journal of thoracic disease · 2019Review
- Perioperative management and outcomes of minimally invasive esophagectomy: case study of a high-volume tertiary center in Taiwan.Journal of thoracic disease · 2018Article
- [Profit center analysis of esophagectomy : Economical analysis of transthoracic esophagectomy depending on postoperative complications].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2018Article
- Enhanced recovery after surgery (ERAS) programs for esophagectomy protocol for a systematic review and meta-analysis.Medicine · 2018Article
- Integrated Care Planning for Cancer Patients: A Scoping Review.International journal of integrated care · 2017Article
- Evolution in the Treatment of Esophageal Disease at a Single Academic Institution: 2004-2013.Journal of laparoendoscopic & advanced surgical techniques. Part A · 2017Article
- Regional Multiteam Systems in Cancer Care Delivery.Journal of oncology practice · 2016Article
- Multidisciplinary treatment of T1a adenocarcinoma in Barrett's esophagus: contemporary comparison of endoscopic and surgical treatment in physiologically fit patients.Surgical endoscopy · 2016Article
- [Perioperative management of transthoracic oesophagectomies : Fundamentals of interdisciplinary care and new approaches to accelerated recovery after surgery].Der Anaesthesist · 2016Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study is to determine the effect of the implementation and evolution of a multidisciplinary esophagectomy care pathway on postoperative outcomes over a 20-year experience. STUDY
designAll patients undergoing esophagectomy for cancer between 1991 and 2012 were included. Patients were divided into four groups (Gp1 1991-1996, Gp2 1997-2002, Gp3 2003-2007, and Gp4 2008-2012).
resultsFive hundred and ninety-five patients were included (Gp1 92, Gp2 159, Gp3 161, and Gp4 183). Age remained consistent over time; however, a progressive significant increase was observed in BMI and Charlson comorbidity index. Increases were also noted in patients with clinical stage III cancers, in the use of neoadjuvant chemoradiotherapy, in salvage esophagectomy and in the utilization of pretreatment jejunostomy. We observed a significant reduction in estimated blood loss (EBL) and operative room IV fluid administration (ORFA) during the study period. Median ICU stay and length of hospital stay (LOS) (10 (5-50) to 8 (5-115) days) decreased over time. In-hospital mortality (0.3 %) and postoperative complications remained consistent over time. cumulative sum (CUSUM) analysis showed that EBL, ORFA, and LOS all declined during the study period, reaching mean values at case 120, 310, and 175, respectively.
conclusionsThe results of this study show that process improvement within the pathway is likely more significant than the level of comorbidities, application of neoadjuvant chemoradiation, or technical approach in patients undergoing esophagectomy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.