Database research part <b>Ⅶ</b>: characteristics of colorectal cancer surgery (Ⅰ)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Xiaodong ¹ , LIU Jianbo ^1,2 , YOU Yixian ^1,2 ,  LI Li ¹

1. Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LI Li, Email: drlili116@126.com

Keywords：

colorectal cancer; database; big data; type of operation; enterostomy; medical quality

DOI：

10.7507/1007-9424.202007023

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).Methods The DACCA version selected for this data analysis was the updated version on April 16th, 2020. The data items included timing of operation, types of operative procedure, radical resection level of operation, patient’s wish of anus-reserving, types of stomy, date of stoma closure, surgical approaches, extended resection, and type of intersphincteric resection (ISR). The data item interval of stoma closure was added, and the selected data items were statistically analyzed.Results The total number of medical records (data rows) that met the criteria was 11 757, including 2 729 valid data on the timing of operation (23.2%), 11 389 valid data on the types of operative procedure (96.9%), 4 255 valid data on the radical resection level of operation (36.2%), 3 803 valid data on patient’s wish of anus-reserving (32.3%), 4 377 valid data on types of stomy (37.2%), 989 valid data on date of stoma closure (8.4%), 4 418 valid data on surgical approaches (37.6%), 3 941 valid data on extended resection (33.5%), and 1 156 valid data on type of ISR (9.8%). In the timing of operation, the most cases were performed immediately after discovery or neoadjuvant completion (915, 33.5%). In types of operative procedure, ultra low anterior resection (ULAR), right hemicolectomy (RHC), and low anterior resection (LAR) were the most, including 1 986 (17.4%), 1 412 (12.4%), and 1 041 (9.1%) lines. Respectively in the colon and rectal cancer surgery, the proportion of RHC (50.0%) and ULAR (26.0%) was the highest, with 172 (26.1%) and 815 (27.9%) extended resection. In ISR surgery the majority was ISR-2 (741, 64.1%). In radical resection level of operation, the number of R0 was the largest with 2 575 (60.5%) lines. In patient’s wish of anus-reserving, positive and rational were the most with 1 811 (47.6%) and 1 440 (37.9%) lines, respectively. And in types of stomy, there were 2 628 lines (60.0%) without stoma and 1 749 cases (40.0%) with stoma, among which the most lines were right lower ileum stoma (612, 35.0%). The minimum value, maximum value, and median value of interval of stoma closure were 0 d, 2 678 d and 112 d. The linear regression prediction of date of stoma closure by year was =9.234 3x+22.394 (R²=0.2928, P=0.07). In the surgical approaches, the majority was standard with 3 182 (72.0%) lines.Conclusions In the DACCA, rectal cancer surgery is still the majority, and ULAR is the most type. The application of extended resection in both colon and rectal cancer has important significance. The data related to stoma are diversified and need to be further studied.

Citation： WANG Xiaodong, LIU Jianbo, YOU Yixian, LI Li. Database research part Ⅶ: characteristics of colorectal cancer surgery (Ⅰ). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(8): 1005-1011. doi: 10.7507/1007-9424.202007023 Copy

1.	汪晓东, 安丽珉, 李立. 数据库研究第二部分: 结直肠癌的住院流程管理. 中国普外基础与临床杂志, 2019, 26(4): 469-475.
2.	汪晓东, 陈梦然, 曾渝, 等. 数据库研究第五部分:结直肠癌的肿瘤特征. 中国普外基础与临床杂志, 2020, 27(2): 196-208.
3.	汪晓东, 李立. 数据库建设第一部分: 个人数据的标签与结构化. 中国普外基础与临床杂志, 2019, 26(3): 335-342.
4.	汪晓东, 李希, 何欣林, 等. 数据库研究第一部分: 区域性医疗中心的结直肠癌与人群特征. 中国普外基础与临床杂志, 2019, 26(2): 212-220.
5.	汪晓东, 刘健博, 安丽珉, 等. 数据库建设第四部分: 结直肠癌的术前专科检查与评估的标签与结构化. 中国普外基础与临床杂志, 2019, 26(11): 1337-1341.
6.	汪晓东, 刘健博, 安丽珉, 等. 数据库研究第四部分: 结直肠癌的术前专科检查与评估. 中国普外基础与临床杂志, 2019, 26(10): 1230-1238.
7.	汪晓东, 刘健博, 李立. 数据库建设第三部分:结直肠癌内外科合并症及术前体质状态的标签与结构化. 中国普外基础与临床杂志, 2019, 26(9): 1110-1115.
8.	汪晓东, 刘健博, 李立. 数据库建设第五部分•结直肠癌的肿瘤特征—模块的设计 (二). 中国普外基础与临床杂志, 2020, 27(4): 483-488.
9.	汪晓东, 刘健博, 李立. 数据库建设第五部分: 结直肠癌的肿瘤特征—模块的设计 (一). 中国普外基础与临床杂志, 2020, 27(3): 345-349.
10.	汪晓东, 刘健博, 何欣林, 等. 数据库研究第六部分: 结直肠癌的分期策略. 中国普外基础与临床杂志, 2020, 27(6): 739-746.
11.	汪晓东, 刘健博, 张诗, 等. 数据库研究第三部分: 结直肠癌的内外科合并症及术前体质状态. 中国普外基础与临床杂志, 2019, 26(8): 985-991.
12.	汪晓东, 吕炘沂, 黄明君, 等. 数据库建设第二部分: 结直肠癌住院流程管理的标签与结构化. 中国普外基础与临床杂志, 2019, 26(7): 852-855.
13.	刘健博, 吕炘沂, 邹雨恒, 等. 多周期新辅助化疗联合阿帕替尼对进展期直肠癌的疗效评价: 基于 DACCA 数据库的辅助研究. 中国普外基础与临床杂志, 2019, 26(6): 728-734.
14.	刘健博, 由屹先, 邹雨恒, 等. 数据库辅助研究: 结直肠癌新辅助治疗的应用—基于 DACCA 的华西真实世界数据报道. 中国普外基础与临床杂志, 2019, 26(12): 1467-1475.
15.	于瑞璇, 何欣林, 张秋露, 等. 华西 DACCA 的辅助研究: 单独的新辅助化疗不会影响直肠癌术后近期的肛门功能. 中国普外基础与临床杂志, 2019, 26(5): 595-601.
16.	李立. 结直肠癌外科应用技术的规范与创新 (十五). 中国普外基础与临床杂志, 2008, 15(3): 215-217.
17.	Rödel C, Hofheinz R, Fokas E. Rectal cancer: neoadjuvant chemoradiotherapy. Best Pract Res Clin Gastroenterol, 2016, 30(4): 629-639.
18.	NCCN. The NCCN colon cancer clinical practice guidelines in oncology (version 3.2020). https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf.
19.	NCCN. The NCCN rectal cancer clinical practice guidelines in oncology (version 4.2020). https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf.
20.	Kuipers EJ, Grady WM, Lieberman D, et al. Colorectal cancer. Nat Rev Dis Primers, 2015, 1: 15065.
21.	Nasti G, Ottaiano A, Berretta M, et al. Pre-operative chemotherapy for colorectal cancer liver metastases: an update of recent clinical trials. Cancer Chemother Pharmacol, 2010, 66(2): 209-218.
22.	Matsunaga R, Nishizawa Y, Saito N, et al. Anal function after surgery for low-lying rectal cancer: comparison of mechanical and hand-sewn coloanal anastomosis. Dig Surg, 2017, 34(6): 469-475.
23.	Cheong C, Oh SY, Choi SJ, et al. Ultralow anterior resection and coloanal anastomosis for low-lying rectal cancer: an appraisal based on bowel function. Dig Surg, 2019, 36(5): 409-417.
24.	Liang L, Zeng JH, Qin XG, et al. Distinguishable prognostic signatures of left- and right-sided colon cancer: a study based on sequencing data. Cell Physiol Biochem, 2018, 48(2): 475-490.
25.	Helvaci K, Eraslan E, Yildiz F, et al. Comparison of clinicopathological and survival features of right and left colon cancers. J BUON, 2019, 24(5): 1845-1851.
26.	McCourt M, Armitage J, Monson JRT. Rectal cancer. Surgeon, 2009, 7(3): 162-169.
27.	Knol J, Keller DS. Total mesorectal excision technique-past, present, and future. Clin Colon Rectal Surg, 2020, 33(3): 134-143.
28.	Coroş MF, Sorlea S, Hintea A, et al. Indications of a defunctioning stoma in colorectal anastomosis–our experience and review of the literature. Chirurgia (Bucur), 2016, 111(2): 138-143.
29.	Tan WS, Tang CL, Shi L, et al. Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer. Br J Surg, 2009, 96(5): 462-472.
30.	汪晓东, 刘健博, 李立. 数据库建设第六部分: 结直肠癌分期的标签与结构化. 中国普外基础与临床杂志, 2020, 27(7): 873-879.
31.	侯天春, 沈卿诚, 柏金喜, 等. 国内手术难度目录管理评价方法的比较与关联构建. 中国医院管理, 2020, 40(1): 46-49, 53.
32.	Meng Z, Hui W, Cai Y, et al. The effects of DRGs-based payment compared with cost-based payment on inpatient healthcare utilization: a systematic review and meta-analysis. Health Policy, 2020, 124(4): 359-367.
33.	陈小龙, 邓磊, 汪晓东, 等. 经肛内外括约肌间切除术后肿瘤学效果及影响因素的研究进展. 中国普外基础与临床杂志, 2010, 17(5): 515-518.
34.	甘志明, 马琛, 汪晓东, 等. 经括约肌间切除术治疗超低位直肠/肛管癌的疗效分析. 四川医学, 2013, 34(9): 1303-1305.
35.	欧阳书睿, 陈华, 邓磊, 等. 直肠肛管癌选择经括约肌间切除术的多因素分析. 肿瘤防治研究, 2011, 38(7): 803-805, 813.
36.	汪晓东, 肖凌, 邓磊, 等. 括约肌间切除术治疗超低位直肠癌的研究进展. 外科理论与实践, 2009, 14(3): 370-373.
37.	Denost Q, Rullier E. Intersphincteric resection pushing the envelope for sphincter preservation. Clin Colon Rectal Surg, 2017, 30(5): 368-376.
38.	汪晓东, 李立. 真实场景与大数据下的整体微创理念, 大幅提高结直肠癌远期生存率. 中国普外基础与临床杂志, 2019, 26(1): 92-95.
39.	Hsiao WC, Braun P, Becker ER, et al. The Resource-Based Relative Value Scale. Toward the development of an alternative physician payment system. JAMA, 1987, 258(6): 799-802.

1. 汪晓东, 安丽珉, 李立. 数据库研究第二部分: 结直肠癌的住院流程管理. 中国普外基础与临床杂志, 2019, 26(4): 469-475.
2. 汪晓东, 陈梦然, 曾渝, 等. 数据库研究第五部分:结直肠癌的肿瘤特征. 中国普外基础与临床杂志, 2020, 27(2): 196-208.
3. 汪晓东, 李立. 数据库建设第一部分: 个人数据的标签与结构化. 中国普外基础与临床杂志, 2019, 26(3): 335-342.
4. 汪晓东, 李希, 何欣林, 等. 数据库研究第一部分: 区域性医疗中心的结直肠癌与人群特征. 中国普外基础与临床杂志, 2019, 26(2): 212-220.
5. 汪晓东, 刘健博, 安丽珉, 等. 数据库建设第四部分: 结直肠癌的术前专科检查与评估的标签与结构化. 中国普外基础与临床杂志, 2019, 26(11): 1337-1341.
6. 汪晓东, 刘健博, 安丽珉, 等. 数据库研究第四部分: 结直肠癌的术前专科检查与评估. 中国普外基础与临床杂志, 2019, 26(10): 1230-1238.
7. 汪晓东, 刘健博, 李立. 数据库建设第三部分:结直肠癌内外科合并症及术前体质状态的标签与结构化. 中国普外基础与临床杂志, 2019, 26(9): 1110-1115.
8. 汪晓东, 刘健博, 李立. 数据库建设第五部分•结直肠癌的肿瘤特征—模块的设计 (二). 中国普外基础与临床杂志, 2020, 27(4): 483-488.
9. 汪晓东, 刘健博, 李立. 数据库建设第五部分: 结直肠癌的肿瘤特征—模块的设计 (一). 中国普外基础与临床杂志, 2020, 27(3): 345-349.
10. 汪晓东, 刘健博, 何欣林, 等. 数据库研究第六部分: 结直肠癌的分期策略. 中国普外基础与临床杂志, 2020, 27(6): 739-746.
11. 汪晓东, 刘健博, 张诗, 等. 数据库研究第三部分: 结直肠癌的内外科合并症及术前体质状态. 中国普外基础与临床杂志, 2019, 26(8): 985-991.
12. 汪晓东, 吕炘沂, 黄明君, 等. 数据库建设第二部分: 结直肠癌住院流程管理的标签与结构化. 中国普外基础与临床杂志, 2019, 26(7): 852-855.
13. 刘健博, 吕炘沂, 邹雨恒, 等. 多周期新辅助化疗联合阿帕替尼对进展期直肠癌的疗效评价: 基于 DACCA 数据库的辅助研究. 中国普外基础与临床杂志, 2019, 26(6): 728-734.
14. 刘健博, 由屹先, 邹雨恒, 等. 数据库辅助研究: 结直肠癌新辅助治疗的应用—基于 DACCA 的华西真实世界数据报道. 中国普外基础与临床杂志, 2019, 26(12): 1467-1475.
15. 于瑞璇, 何欣林, 张秋露, 等. 华西 DACCA 的辅助研究: 单独的新辅助化疗不会影响直肠癌术后近期的肛门功能. 中国普外基础与临床杂志, 2019, 26(5): 595-601.
16. 李立. 结直肠癌外科应用技术的规范与创新 (十五). 中国普外基础与临床杂志, 2008, 15(3): 215-217.
17. Rödel C, Hofheinz R, Fokas E. Rectal cancer: neoadjuvant chemoradiotherapy. Best Pract Res Clin Gastroenterol, 2016, 30(4): 629-639.
18. NCCN. The NCCN colon cancer clinical practice guidelines in oncology (version 3.2020). https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf.
19. NCCN. The NCCN rectal cancer clinical practice guidelines in oncology (version 4.2020). https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf.
20. Kuipers EJ, Grady WM, Lieberman D, et al. Colorectal cancer. Nat Rev Dis Primers, 2015, 1: 15065.
21. Nasti G, Ottaiano A, Berretta M, et al. Pre-operative chemotherapy for colorectal cancer liver metastases: an update of recent clinical trials. Cancer Chemother Pharmacol, 2010, 66(2): 209-218.
22. Matsunaga R, Nishizawa Y, Saito N, et al. Anal function after surgery for low-lying rectal cancer: comparison of mechanical and hand-sewn coloanal anastomosis. Dig Surg, 2017, 34(6): 469-475.
23. Cheong C, Oh SY, Choi SJ, et al. Ultralow anterior resection and coloanal anastomosis for low-lying rectal cancer: an appraisal based on bowel function. Dig Surg, 2019, 36(5): 409-417.
24. Liang L, Zeng JH, Qin XG, et al. Distinguishable prognostic signatures of left- and right-sided colon cancer: a study based on sequencing data. Cell Physiol Biochem, 2018, 48(2): 475-490.
25. Helvaci K, Eraslan E, Yildiz F, et al. Comparison of clinicopathological and survival features of right and left colon cancers. J BUON, 2019, 24(5): 1845-1851.
26. McCourt M, Armitage J, Monson JRT. Rectal cancer. Surgeon, 2009, 7(3): 162-169.
27. Knol J, Keller DS. Total mesorectal excision technique-past, present, and future. Clin Colon Rectal Surg, 2020, 33(3): 134-143.
28. Coroş MF, Sorlea S, Hintea A, et al. Indications of a defunctioning stoma in colorectal anastomosis–our experience and review of the literature. Chirurgia (Bucur), 2016, 111(2): 138-143.
29. Tan WS, Tang CL, Shi L, et al. Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer. Br J Surg, 2009, 96(5): 462-472.
30. 汪晓东, 刘健博, 李立. 数据库建设第六部分: 结直肠癌分期的标签与结构化. 中国普外基础与临床杂志, 2020, 27(7): 873-879.
31. 侯天春, 沈卿诚, 柏金喜, 等. 国内手术难度目录管理评价方法的比较与关联构建. 中国医院管理, 2020, 40(1): 46-49, 53.
32. Meng Z, Hui W, Cai Y, et al. The effects of DRGs-based payment compared with cost-based payment on inpatient healthcare utilization: a systematic review and meta-analysis. Health Policy, 2020, 124(4): 359-367.
33. 陈小龙, 邓磊, 汪晓东, 等. 经肛内外括约肌间切除术后肿瘤学效果及影响因素的研究进展. 中国普外基础与临床杂志, 2010, 17(5): 515-518.
34. 甘志明, 马琛, 汪晓东, 等. 经括约肌间切除术治疗超低位直肠/肛管癌的疗效分析. 四川医学, 2013, 34(9): 1303-1305.
35. 欧阳书睿, 陈华, 邓磊, 等. 直肠肛管癌选择经括约肌间切除术的多因素分析. 肿瘤防治研究, 2011, 38(7): 803-805, 813.
36. 汪晓东, 肖凌, 邓磊, 等. 括约肌间切除术治疗超低位直肠癌的研究进展. 外科理论与实践, 2009, 14(3): 370-373.
37. Denost Q, Rullier E. Intersphincteric resection pushing the envelope for sphincter preservation. Clin Colon Rectal Surg, 2017, 30(5): 368-376.
38. 汪晓东, 李立. 真实场景与大数据下的整体微创理念, 大幅提高结直肠癌远期生存率. 中国普外基础与临床杂志, 2019, 26(1): 92-95.
39. Hsiao WC, Braun P, Becker ER, et al. The Resource-Based Relative Value Scale. Toward the development of an alternative physician payment system. JAMA, 1987, 258(6): 799-802.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Database research part Ⅶ: characteristics of colorectal cancer surgery (Ⅰ)

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