P-0068 - Analysis of a Clinical Pathway for Elective Gastrectomy
|Date||28 June 2014|
|Event||World GI 2014|
|Topics|| Gastric Cancer
Surgery and/or Radiotherapy of Cancer
|Presenter||Don Min Yong|
|Citation||Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165|
D. Min Yong1, S. Kim2
Clinical pathways have been developed for operative procedures with documented improvements in length of stay and cost without compromising outcome. This study evaluated a clinical pathway for an elective gastrectomy and examined patient outcomes after implementation of a 9-day discharge pathway.
A 9-day clinical pathway for elective gastrectomy has been applied from 2008 at Chosun university hospital. Retrospectively, we analyzed 252 patients who underwent an elective gastrectomy from January 2009 to April 2013.
The completion rate of the clinical pathway was 45.6% (115/252). Mean length of stay was 11.7 ± 8.6 (8 – 59 days). Readmission rate was 4.4% (11/252). In multivariate analysis, laparoscopic gastrectomy (odds ratio = 0.511) and subtotal gastrectomy (odds ratio = 5.251) were important factors to fail clinical pathway. Causes of failure for clinical pathway were intra-abdominal complications (32.8%), patient factors (29.9%) and wound complications (21.9%).
The clinical pathway for an elective gastrectomy might be divided 4 subgroups, according to approach methods and extent of resection in gastric cancer surgery. To reduce a failure of clinical pathway, the proper management of surgical wounds and patients might to be required.