Textbook outcome in gastric surgery, what implications does it have on survival?

Abstract

Introduction: The textbook outcome (TO) is a multidimensional measure to assess the quality of healthcare practice. This is reflected as the "ideal" surgical result, attending to a series of indicators or established reference points that are adapted depending on the surgical disease that we want to analyze. There are few references and series published about TO, all of them very recent.

Objective: We present a series of gastric surgery from the TO perspective and we analyze its impact on survival.

Method: Retrospective observational study of all gastric neoplasms operated on in our center.

Period: January 2015-December 2020. The criteria for TO were: margins R0, >15 lymph nodes in the histological study, no Clavien-Dindo complications > IIIa, hospital stay < 21 days, no mortality or readmission in the 30 postoperative days. A comparative analysis was performed between the TO group versus the non-TO group.

Results: 91 patients were operated on. We reached the TO in 34.1% of the patients. The variable >15 lymph nodes was the one that most affected to achieve a TO. When performing the survival analysis, we obtained that the group in which the TO was obtained had a greater survival (p < 0.008).

Conclusion: In our series, obtaining the TO has an impact on survival which 34,1% of degree of compliance.

Keywords: Benchmark; Calidad; Cáncer gástrico; Gastrectomy; Gastrectomía; Gastric cancer; Indicador; Resultado de libro; Surgical quality; Textbook outcome.