Introduction:
Significant number of fundoplication is performed annually across Australia. Robust database is integral for quality control and improvement. However, comparison of outcomes is challenging due to separate data collection between centres, highlighting the need for a nationwide database. To facilitate this, we compared the databases from three high volume Upper GI units in Queensland, South Australia and Victoria.
Methods:
Collected variables were grouped into pre-operative, perioperative, post–operative domains. The variables and methods of collection were compared.
Results:
Pre-operative patient and proceduralists demographics were similarly collected in all databases. Although presenting symptoms, pre-operative diagnostic tests were collected, the number of tests included, their parameters and means to collect them varied considerably. Novel tests such as impedance, scintigraphy was not recorded in any database. Blood results or lung function testing was only recorded in one database.
In peri-operative domain, although operation type, approach, the use of mesh/ bougie, intra-operative complication was recorded in all databases, the levels of details differed substantially. The discrepancy was most notable in the documentation of hiatal hernia and repair description.
Greatest variation was noted in the post-operative domain particularly with the follow up duration and frequency. Although immediate post-operative morbidity, mortality was similarly recorded, medium/ long term variables regarding dysphagia, recurrence of symptoms were collected using different rating scales.
Conclusion
Although similar datapoints were collected, the collection methods vary significantly between centres. This difference needs to be resolved by a consensus process before a nationwide database can be developed.