EP.WE.324Variation Between Observed and Perceived Volume of Antireflux Operations Completed by Upper-Gastrointestinal Surgeons at a University Teaching Hospital

Abstract Aims Increased institutional volume and surgeon experience with antireflux surgery has been shown to improve patient outcomes. We have sought to illustrate the discrepancy between the perceived (self-reported) and observed annual volume of anti-reflux operations completed by each surgeon. Method A retrospective questionnaire was delivered to all upper-gastrointestinal (UGI) surgeons performing antireflux surgeries (ARS) at a University Teaching Hospital. Surgeons were asked to estimate the quantity of NHS antireflux cases completed annually. Objective, anonymised data was retrieved from the Surgical Workload Outcomes Audit Database (SWORD) from 2017 to 2020 for comparison. Results 127 ARS were completed by 6 UGI consultants between January 2018 and December 2020. The median number of ARS completed per surgeon was 5 (2-10) in 2018, 9 (4-11) in 2019 and 10 (1-11) in 2020. Conversely, the median number of self-reported annual procedures per surgeon was 20 (12-35). On average, participants overestimated the number of NHS ARS completed by 14.5 (4-27) cases or a factor of 2.08. No surgeon correctly or underestimated the number of ARS performed. Conclusion We conclude that self-reported operation volume should not be relied upon for the purposes of assessment or audit. Estimations of annual ARS procedures could be up to triple that suggested by objective data. Our data supports the importance of local or national data sets like SWORD to give an accurate reflection of practice and to allow individuals to compare their performance against their peers.

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788 Variation Between Observed and Perceived Volume of Antireflux Operations Completed by Upper-Gastrointestinal Surgeons at a University Teaching Hospital

British Journal of Surgery ◽

10.1093/bjs/znab259.673 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

C Ashmore ◽

D Hunter ◽

A Boddy

Keyword(s):

Patient Outcomes ◽

Teaching Hospital ◽

University Teaching ◽

Self Assessment ◽

Surgeon Experience ◽

Institutional Volume ◽

Antireflux Operations ◽

Improve Patient ◽

Retrospective Questionnaire ◽

Upper Gastrointestinal

Abstract Aim Increased institutional volume and surgeon experience with antireflux surgery has been shown to improve patient outcomes. We have sought to illustrate the discrepancy between the perceived (self-reported) and observed annual volume of anti-reflux operations completed by each surgeon. Method A retrospective questionnaire was delivered to all upper-gastrointestinal (UGI) surgeons performing antireflux surgeries (ARS) at a University Teaching Hospital. Surgeons were asked to estimate the quantity of NHS antireflux cases completed annually. Objective, anonymised data was retrieved from the Surgical Workload Outcomes Audit Database (SWORD) from 2017 to 2020 for comparison. Results 127 ARS were completed by 6 UGI consultants between January 2018 and December 2020. The average number of ARS completed per surgeon was 5.8 (2-10) in 2018, 8.7 (4-11) in 2019 and 6.7 (1-11) in 2020. Conversely, the average number of self-reported annual procedures per surgeon was 22.4 (12-35). On average, participants overestimated the number of NHS ARS completed by 14.5 (4-27) cases or a factor of 2.08. No surgeon correctly or underestimated the number of ARS performed. Conclusions We conclude that self-reported operation volume should not be relied upon for the purposes of assessment or audit. Estimations of annual ARS procedures could be up to triple that suggested by objective data. We recommend that all surgeons maintain a database of ARS for the purpose of self-assessment and audit.

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Demographic profile and endoscopic findings among patients with upper gastrointestinal bleeding in Ahmadu Bello University Teaching Hospital, Zaria, North-Western Nigeria

Nigerian Journal of Clinical Practice ◽

10.4103/njcp.njcp_69_20 ◽

2020 ◽

Vol 23 (8) ◽

pp. 1162

Author(s):

M Manko ◽

AK Bello ◽

MF Mohammed ◽

PO Egbegbedia ◽

M Daniyan ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Teaching Hospital ◽

Upper Gastrointestinal Bleeding ◽

University Teaching ◽

Demographic Profile ◽

Endoscopic Findings ◽

Upper Gastrointestinal ◽

North Western

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Upper gastrointestinal endoscopy in children: The Lagos University Teaching Hospital experience

South African Journal of Child Health ◽

10.7196/sajch.2016.v10i4.1116 ◽

2016 ◽

Vol 10 (4) ◽

pp. 207 ◽

Cited By ~ 1

Author(s):

Oluwafunmilayo Funke Adeniyi ◽

Olufunmi A Lesi ◽

Emuobor A Odeghe ◽

Oyebola Adekola ◽

Abiola Oduwole

Keyword(s):

Teaching Hospital ◽

Gastrointestinal Endoscopy ◽

University Teaching ◽

Upper Gastrointestinal Endoscopy ◽

Hospital Experience ◽

Upper Gastrointestinal

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SP5.1.13 Upper gastrointestinal (UGI) mural thickening on Computed Tomography (CT) and its significance in the multi-disciplinary team (MDT) pathway

British Journal of Surgery ◽

10.1093/bjs/znab361.122 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Christopher Ashmore ◽

David Hunter ◽

Richard Kenningham ◽

David Bowrey

Keyword(s):

Computed Tomography ◽

Retrospective Analysis ◽

Hiatal Hernia ◽

Teaching Hospital ◽

Hiatus Hernia ◽

Benign Disease ◽

University Teaching ◽

High Index Of Suspicion ◽

Upper Gastrointestinal ◽

Multi Disciplinary Team

Abstract Aims Patients are frequently referred to the UGI MDT based on CT reported thickening of either the oesophagus, stomach or duodenum. We have sought to illustrate the efficacy of CT within the UGI cancer referral pathway. Method A retrospective analysis was carried out on patients referred to the UGI MDT at a University Teaching Hospital over a 22-month period. Patients referred with CT evidence of UGI tract thickening prior to endoscopy were included. CT findings were correlated with symptomatology, subsequent endoscopy and histology findings. Results 442 patients were referred to the UGI MDT between April 2014 and February 2016. 125 were referred for CT thickening alone (67 (53.2%) oesophageal, 49 (39.2%) gastric, 9 (7.2%) duodenal). 49 (39.2%) patients were subsequently diagnosed with UGI cancer, 57 (45.6%) had evidence of benign disease and 18 (14.4%) patients had no abnormality evident on endoscopy. CT thickening of 15mm and above was significantly more likely be malignant versus thickening less than 15mm [42/87 (48.3%) vs 7/38 (18.4%); p < 0.05]. Patients with thickening in the presence of a hiatus hernia were significantly less likely to have an associated cancer vs those without [3/26 (13%) vs 20/42 (51.1%); p < 0.05]. Conclusion We conclude that patients should not be referred for MDT opinion on CT evidence of UGI thickening alone. All patients should have an endoscopy prior to referral, particularly those with a hiatal hernia on CT. A high index of suspicion for malignancy should be adopted in patients with thickening greater than 15mm on imaging.

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