Abstract
Abstract Background Length of stay (LOS) after oesophagectomy is an indicator of efficiency of patient care, practice style, complication rates and their management. Median LOS in specialist centres is 10 to 12 days. The desired LOS as a quality performance indicator (QPI) has recently been reduced from 21 days to 14 days in our country. The aim of this study was to see if this change in LOS could be validated by differences in long term outcomes. Methods A total of 110 consecutive patients who underwent esophagectomy for cancer between 2011 and 2020 were included in this study. We compared the statistical significance in overall survival of patients with LOS 14 days and 21 days as two separate datasets. Overall survival (OS) in months was calculated from date of surgery to death or otherwise censored. 4 patients who died in hospital were excluded. Statistical analysis was conducted using IBM SPSSv25. Results 110 consecutive patients were included in this study. The median postoperative stay for all patients was 18 days with an interquartile range of 14 to 26 days. Kaplan Meier survival comparison with Log Rank of OS with LOS 21 days showed no difference in survival between patients with LOS ≤ 21 days and LOS > 21 days (p = 0.487). A similar comparison showed a statistically significant difference in survival in patients with LOS≤ 14 days and LOS > 14 days (p = 0.034), with a mean survival (months) of 80.9 and 60.2 respectively. Conclusions LOS after surgery is a marker of patient health, care efficiency and uncomplicated recovery. No clear LOS with patient benefits has been defined in the past. A LOS of 14 days after oesophagectomy in our cohort is interestingly an indicator and predictor of long-term survival. Further subgroup analysis of patient and tumour characteristics are being carried out to see if we can predict patients who can be discharged in less than 14 days. These characteristics can then be used to predict and study long term survival after oesophagectomy.
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