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.	汪曉東, 安麗珉, 李立. 數據庫研究第二部分: 結直腸癌的住院流程管理. 中國普外基礎與臨床雜志, 2019, 26(4): 469-475.
2.	汪曉東, 陳夢然, 曾渝, 等. 數據庫研究第五部分:結直腸癌的腫瘤特征. 中國普外基礎與臨床雜志, 2020, 27(2): 196-208.
3.	汪曉東, 李立. 數據庫建設第一部分: 個人數據的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(3): 335-342.
4.	汪曉東, 李希, 何欣林, 等. 數據庫研究第一部分: 區域性醫療中心的結直腸癌與人群特征. 中國普外基礎與臨床雜志, 2019, 26(2): 212-220.
5.	汪曉東, 劉健博, 安麗珉, 等. 數據庫建設第四部分: 結直腸癌的術前專科檢查與評估的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(11): 1337-1341.
6.	汪曉東, 劉健博, 安麗珉, 等. 數據庫研究第四部分: 結直腸癌的術前專科檢查與評估. 中國普外基礎與臨床雜志, 2019, 26(10): 1230-1238.
7.	汪曉東, 劉健博, 李立. 數據庫建設第三部分:結直腸癌內外科合并癥及術前體質狀態的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(9): 1110-1115.
8.	汪曉東, 劉健博, 李立. 數據庫建設第五部分?結直腸癌的腫瘤特征—模塊的設計 (二). 中國普外基礎與臨床雜志, 2020, 27(4): 483-488.
9.	汪曉東, 劉健博, 李立. 數據庫建設第五部分: 結直腸癌的腫瘤特征—模塊的設計 (一). 中國普外基礎與臨床雜志, 2020, 27(3): 345-349.
10.	汪曉東, 劉健博, 何欣林, 等. 數據庫研究第六部分: 結直腸癌的分期策略. 中國普外基礎與臨床雜志, 2020, 27(6): 739-746.
11.	汪曉東, 劉健博, 張詩, 等. 數據庫研究第三部分: 結直腸癌的內外科合并癥及術前體質狀態. 中國普外基礎與臨床雜志, 2019, 26(8): 985-991.
12.	汪曉東, 呂炘沂, 黃明君, 等. 數據庫建設第二部分: 結直腸癌住院流程管理的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(7): 852-855.
13.	劉健博, 呂炘沂, 鄒雨恒, 等. 多周期新輔助化療聯合阿帕替尼對進展期直腸癌的療效評價: 基于 DACCA 數據庫的輔助研究. 中國普外基礎與臨床雜志, 2019, 26(6): 728-734.
14.	劉健博, 由屹先, 鄒雨恒, 等. 數據庫輔助研究: 結直腸癌新輔助治療的應用—基于 DACCA 的華西真實世界數據報道. 中國普外基礎與臨床雜志, 2019, 26(12): 1467-1475.
15.	于瑞璇, 何欣林, 張秋露, 等. 華西 DACCA 的輔助研究: 單獨的新輔助化療不會影響直腸癌術后近期的肛門功能. 中國普外基礎與臨床雜志, 2019, 26(5): 595-601.
16.	李立. 結直腸癌外科應用技術的規范與創新 (十五). 中國普外基礎與臨床雜志, 2008, 15(3): 215-217.
17.	R?del 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.	Coro? 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.	汪曉東, 劉健博, 李立. 數據庫建設第六部分: 結直腸癌分期的標簽與結構化. 中國普外基礎與臨床雜志, 2020, 27(7): 873-879.
31.	侯天春, 沈卿誠, 柏金喜, 等. 國內手術難度目錄管理評價方法的比較與關聯構建. 中國醫院管理, 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.	陳小龍, 鄧磊, 汪曉東, 等. 經肛內外括約肌間切除術后腫瘤學效果及影響因素的研究進展. 中國普外基礎與臨床雜志, 2010, 17(5): 515-518.
34.	甘志明, 馬琛, 汪曉東, 等. 經括約肌間切除術治療超低位直腸/肛管癌的療效分析. 四川醫學, 2013, 34(9): 1303-1305.
35.	歐陽書睿, 陳華, 鄧磊, 等. 直腸肛管癌選擇經括約肌間切除術的多因素分析. 腫瘤防治研究, 2011, 38(7): 803-805, 813.
36.	汪曉東, 肖凌, 鄧磊, 等. 括約肌間切除術治療超低位直腸癌的研究進展. 外科理論與實踐, 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.	汪曉東, 李立. 真實場景與大數據下的整體微創理念, 大幅提高結直腸癌遠期生存率. 中國普外基礎與臨床雜志, 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. 汪曉東, 安麗珉, 李立. 數據庫研究第二部分: 結直腸癌的住院流程管理. 中國普外基礎與臨床雜志, 2019, 26(4): 469-475.
2. 汪曉東, 陳夢然, 曾渝, 等. 數據庫研究第五部分:結直腸癌的腫瘤特征. 中國普外基礎與臨床雜志, 2020, 27(2): 196-208.
3. 汪曉東, 李立. 數據庫建設第一部分: 個人數據的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(3): 335-342.
4. 汪曉東, 李希, 何欣林, 等. 數據庫研究第一部分: 區域性醫療中心的結直腸癌與人群特征. 中國普外基礎與臨床雜志, 2019, 26(2): 212-220.
5. 汪曉東, 劉健博, 安麗珉, 等. 數據庫建設第四部分: 結直腸癌的術前專科檢查與評估的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(11): 1337-1341.
6. 汪曉東, 劉健博, 安麗珉, 等. 數據庫研究第四部分: 結直腸癌的術前專科檢查與評估. 中國普外基礎與臨床雜志, 2019, 26(10): 1230-1238.
7. 汪曉東, 劉健博, 李立. 數據庫建設第三部分:結直腸癌內外科合并癥及術前體質狀態的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(9): 1110-1115.
8. 汪曉東, 劉健博, 李立. 數據庫建設第五部分?結直腸癌的腫瘤特征—模塊的設計 (二). 中國普外基礎與臨床雜志, 2020, 27(4): 483-488.
9. 汪曉東, 劉健博, 李立. 數據庫建設第五部分: 結直腸癌的腫瘤特征—模塊的設計 (一). 中國普外基礎與臨床雜志, 2020, 27(3): 345-349.
10. 汪曉東, 劉健博, 何欣林, 等. 數據庫研究第六部分: 結直腸癌的分期策略. 中國普外基礎與臨床雜志, 2020, 27(6): 739-746.
11. 汪曉東, 劉健博, 張詩, 等. 數據庫研究第三部分: 結直腸癌的內外科合并癥及術前體質狀態. 中國普外基礎與臨床雜志, 2019, 26(8): 985-991.
12. 汪曉東, 呂炘沂, 黃明君, 等. 數據庫建設第二部分: 結直腸癌住院流程管理的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(7): 852-855.
13. 劉健博, 呂炘沂, 鄒雨恒, 等. 多周期新輔助化療聯合阿帕替尼對進展期直腸癌的療效評價: 基于 DACCA 數據庫的輔助研究. 中國普外基礎與臨床雜志, 2019, 26(6): 728-734.
14. 劉健博, 由屹先, 鄒雨恒, 等. 數據庫輔助研究: 結直腸癌新輔助治療的應用—基于 DACCA 的華西真實世界數據報道. 中國普外基礎與臨床雜志, 2019, 26(12): 1467-1475.
15. 于瑞璇, 何欣林, 張秋露, 等. 華西 DACCA 的輔助研究: 單獨的新輔助化療不會影響直腸癌術后近期的肛門功能. 中國普外基礎與臨床雜志, 2019, 26(5): 595-601.
16. 李立. 結直腸癌外科應用技術的規范與創新 (十五). 中國普外基礎與臨床雜志, 2008, 15(3): 215-217.
17. R?del 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. Coro? 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. 汪曉東, 劉健博, 李立. 數據庫建設第六部分: 結直腸癌分期的標簽與結構化. 中國普外基礎與臨床雜志, 2020, 27(7): 873-879.
31. 侯天春, 沈卿誠, 柏金喜, 等. 國內手術難度目錄管理評價方法的比較與關聯構建. 中國醫院管理, 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. 陳小龍, 鄧磊, 汪曉東, 等. 經肛內外括約肌間切除術后腫瘤學效果及影響因素的研究進展. 中國普外基礎與臨床雜志, 2010, 17(5): 515-518.
34. 甘志明, 馬琛, 汪曉東, 等. 經括約肌間切除術治療超低位直腸/肛管癌的療效分析. 四川醫學, 2013, 34(9): 1303-1305.
35. 歐陽書睿, 陳華, 鄧磊, 等. 直腸肛管癌選擇經括約肌間切除術的多因素分析. 腫瘤防治研究, 2011, 38(7): 803-805, 813.
36. 汪曉東, 肖凌, 鄧磊, 等. 括約肌間切除術治療超低位直腸癌的研究進展. 外科理論與實踐, 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. 汪曉東, 李立. 真實場景與大數據下的整體微創理念, 大幅提高結直腸癌遠期生存率. 中國普外基礎與臨床雜志, 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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