P175. MAMMO-50: Mammographic surveillance in breast cancer patients over 50 years of age – The results of the 2 year feasibility study

Abstract

S S75 Aim: To look at all our mastectomies and immediate reconstructions and see whether they have been coded properly on the OPCS system Method: All skin sparing mastectomies and immediate reconstructions with ADM/Implant that were performed over a 6 month period were taken from our central database and the OPCS and HRG codes were compared and to look at the reason why they were inappropriately coded. Results: There were 24 cases covering all 3 consultants. 9 achieved the correct HRG code (JA16Z Mastectomy and reconstruction e £6415). The remaining cases did not get a reconstruction HRG but instead JA07 and JA06 codes which are the HRGs usually assigned to mastectomies. The lost income on these 15 cases alone is about £80,000. Conclusion: Interventions were made and a re-audit will be performed of coding and HRG allocation for 3 months after these interventions. http://dx.doi.org/10.1016/j.ejso.2015.03.211 P174. Role of PEC block in recovery after mastectomy Ramkumar Dhanancheyan, Rajeeva Venkatasamy, Imtiaz Cheema James Cook University Hospital, Middlesbrough, UK Mastectomy is one of the common surgical procedures and accounts for significant bed occupancy. The aim of this audit was to review our practice of analgesic administration to the patients undergoing the procedure and its effect on the length of stay. Methods: Notes of 50 random patients who had undergone mastectomy in a 6 month period were reviewed to collect details of pain scores, analgesic requirements, duration of recovery and hospital stay. Patients having primary reconstruction were excluded. Results: A total of 47 notes were reviewed. Twenty two patients had, in addition to GA, regional analgesia (RA) in the form of Pectoralis (PEC) block. The remaining 25 did not had any PEC block but had local anaesthetic (LA) infiltration (n 1⁄4 12), LA through drain (n 1⁄4 9) or no LA (n 1⁄4 4). There was no significant difference between RA and Non RA group in terms of recovery pain scores and morphine requirement in recovery. RA group had significantly less morphine intra-operatively compared to others. Recovery stay was slightly longer and slightly more patients needed morphine on first postoperative day in Non RA group. More patients in Non RA group stayed in hospital for more than two days (Table 1). Conclusions: In this audit PEC block significantly decreased morphine requirement in perioperative period, though it did not translate to significant reduction in recovery stay. This emphasises the need for a more holistic approach in order to reduce hospital stay and regional block can be an important part of care.