O124 Synchronous colorectal and liver resections for colorectal cancer – use of the National Consultant Information Programme (NCIP) to highlight colorectal surgical practice in England

Abstract

Abstract Introduction The NCIP tool uses HES data collected from Trusts to understand the spread and variation of a range of surgical procedures. This work uses the tool to understand the current practice of synchronous colorectal and liver resection in England and how Covid-19 affected practice. Methods Pseudonymised data was extracted from NCIP dashboards by NHS England Improvement data analysts. The various metrics looked at included surgical approach, number of cases, length of stay (LOS), incidence of stoma maturation and readmission, and mortality. Results 523 elective patients over 17+ years – 244 cases between April 2018-March 2020 and 279 cases between April 2020-March 2022. Most primary tumours were colonic (407), with fewer rectosigmoid (47) and rectal cancers (69). 81.26% of procedures were performed open. 57 centres undertook synchronous colorectal and liver resections, 68.42% of total providers did <10 cases in the 4-year data period. Average LOS was 14 days. Mean stoma rate was 35% in units performing >20 cases (range 21%-58%). 14.90% of patients were readmitted within 30 days. The 90-day mortality was 1.53%. Conclusion There was no impact of the Covid pandemic on current practice, possibly due to reluctance to give chemotherapy in this patient group. There was a significant variation observed at provider level for each procedure sub-group. Data suggests stoma creation within episode is a contributor to higher average LOS, readmission rate and mortality rate. In addition, significant variation observed in stoma formation between units, and a significant number of units are performing a small number of procedures.