Outcome Analysis of Medical Treatment Fees for Perioperative Management of Surgery for Gastric and Esophageal Cancer Using a Questionnaire Survey and the National Clinical Database

<p>Purpose: With the enhancement of recovery after surgery protocols, additional medical fees for perioperative management have been introduced. However, few large-scale reports have investigated the relationship between medical fee items and their impact on complication control in conjunction with clinical data. In this study, we conducted a questionnaire survey on medical fee items related to perioperative management in upper gastrointestinal surgery and analyzed the impact on perioperative complications by linking to the National Clinical Database (NCD). Materials and Methods: A questionnaire survey was administered to departments performing upper gastrointestinal tract surgery at facilities certified by the Japanese Society of Gastroenterological Surgery to assess eight medical fee items related to perioperative management. The results were analyzed by linking to NCD postoperative outcomes: the incidence of postoperative complications, mortality within 30 days after surgery, and length of hospital stay after surgery. Result: Of 884 certified facilities, 633 (71.6%) responded. Adoption of nutrition support and collaboration with dentists resulted in a significantly shorter postoperative hospital stay after distal gastrectomy and total gastrectomy, and significantly lower mortality within 30 days after esophagectomy. Adoption of perioperative oral function management resulted in a significantly shorter hospital stay after any type of surgery and significantly lower mortality within 30 days after esophagectomy. Conclusion: This study revealed a correlation between medical fee items and postoperative complications after surgery for gastric cancer and esophageal cancer.</p>