P205 THREE YEARS EXPERIENCE OF THE FIRST SPECIALIZED ESOPHAGEAL CENTER IN EGYPT

Abstract

Abstract Introduction Subspecialty policy is increasing all over the world aiming to improve the results of heavy esophageal surgeries. Aim To define the impact of having surgical specialized esophageal unit on the volume of patients and the results. Methodology We reviewed all esophageal cases managed in our esophageal specialized department (from May 2016 to May 2019 Group A) and we compared the results to previous 3 years (from May 2013 to May 2016 Group B) and to the international results. Results Esophageal surgeries performed during this period was 394 cases in group A compared to 104 cases in group B. One hundred eighty operations were performed for Gastro esophageal reflux disease (GERD) in group a (45.7%) compared to 61 cases in group B (68.7%). Forty two (10.7%) modified Heller’s cardiomyotomy (Open and laparoscopic) for achalasia were performed in group A compared to 17 cases (16.3%) in group B. Surgeries for malignant lesions were performed for 122 cases (30.9%) in group A compared to 13 cases (12.5%) in group B. Other Esophageal operations were also done for 50 cases (12.7%) in group A compared to 13 cases (12.5%) in group B. Mortalities in group A was 5 cases in benign diseases (1.8%) and 13 cases for malignant cases (10.7%) compared to 7 cases in benign diseases (7.7%) and 5 cases for malignant conditions (23%) in group B. Morbidities in group A was 46 cases in benign diseases (16.9%) and 31cases for malignant cases (25.4%) Compared to 23 cases in the benign diseases (25.2%) and 5 cases for malignant conditions (38.5%) in group B. Our results in group A are comparable to Hospital mortality rates for patients in medium-volume centers (7.5%)(1).Also we approach the International results for morbidities of benign esophageal disease (5.7 to- 12.7%) for fundoplication (2). Conclusion Having a specialized esophageal unit resulted in increase of the volume of patients and improvement of the results.