475. IMPACT OF SURGERY START TIME ON SHORT TERM OUTCOMES OF ELECTIVE ESOPHAGECTOMY FOR CANCER

Abstract

Abstract As the number of patients with esophageal cancer is increasing, it is expected to lead to an increased work for surgeons. However, surgeons would work less effectively with fatigue accumulation during the course of a normal workday. We examined the impact of surgery start time and work load on short-term outcomes of patients undergoing elective esophagectomy for caner. This was a retrospective analysis of a single medical center dataset that included all patients (n = 614) who had undergone elective esophagectomy for cancer between 2010 and 2022. Patients were categorized according to the start times of surgery (AM group: 8am-1pm, n = 491; PM group: 1pm-5pm, n = 123). Post-operative outcomes and short-term survival were taken as primary end point. The baseline characteristics of the AM and PM group were similar. The AM group had longer operation time (443.29±89.31 vs. 410±81.55, p < 0.001). The rate of unplanned conversion to laparotomy from laparoscopy was higher in the PM group with borderline significance (0.2% vs. 0.7%, p= 0.08). Both of the oncological outcomes and the incidence of the postoperative complications were similar between two groups (all p > 0.05). In short term survival, patients in the PM group had higher 180-day mortality (9.3% vs. 16.3%, p= 0.045). Surgery start times might contribute to higher conversion rate in abdominal part of surgery. Otherwise, surgery start times and workload of surgeons during working time did not affect short-term outcomes of elective esophagectomy for cancer.