Recent advances in defining and benchmarking complications after esophagectomy

Esophageal surgery is associated with a relatively high surgical postoperative morbidity rate and accounts for a high share of reoperations compared to other surgical procedures (1). In order to improve quality of care there is an increasing demand for transparency of information that aids in comparing these morbidity-related outcomes across institutions, national audits and trials (2,3). This information can be used to provide feedback to individual centers and assist them with developing targeted quality improvement initiatives that might lead to improved quality of care and better overall outcomes (2,3). However, relevant comparison of outcomes between centers requires consistency in data collection. The lack of standardized definitions for reporting complications so far has hindered fair outcome assessment after esophagectomy (4). It has also resulted in a long debate within the surgical community on which prevalence of complications can be reasonably expected after esophagectomy.