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

Authors：

WANG Xiaodong ¹ , Lü Xinyi ^1,2 , LIU Jianbo ^1,2 ,  LI Li ¹

1. Department of Gastrointestinal Surgery, West China Hospital, 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; medical quality

DOI：

10.7507/1007-9424.202009095

Video：

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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 July 16th, 2020. The data items included operative duration, anatomy (anatomical difficulty), pelvis (pelvic stenosis), obesity (abdominal obesity), adhesion (adhesion in surgical area), mesentery (abnormal mesenteric status), hypertrophy (tissue hypertrophy or organ hypertrophy), intestinal quality, death (risk of death), injury (risk of tissue injury), recurrence (tumor recurrence), metastasis (tumor metastasis), anastomotic leakage (risk of anastomotic leakage), difficulty of operation, prognosis, quality of operation. The selected data items were statistically analyzed.Results Thetotal number of medical records (data rows) that met the criteria was 6 116. Spearman correlation text showed a negative correlation between operative duration and years (r_s=–0.433, P<0.001). In anatomy, pelvis, obesity, adhesion, mesentery, and hypertrophy, the most cases were “normal or basically normal”, and the percentages were 32.55%, 44.52%, 48.68%, 55.79%, 53.36%, and 57.72%, respectively. In quality of intestinal, the highest proportion was “bad” (43.25%). In risk of death, risk of tissue injury, and tumor recurrence, the most cases were “very small”, and the percentages were 69.00%, 94.41%, and 68.21%, respectively. In tumor metastasis, risk of anastomotic leakage, difficulty of operation, prognosis, and quality of operation, the highest proportion were “small” (48.58%), “average” (49.25%), “average” (32.96%), “uncertain” (45.65%), and “very good” (39.85%).Conclusions In the DACCA, the intestinal quality is characteristic of difficulty in operation, and in the evaluation of operation quality, the judgment of anastomotic leakage deserves much more attention. However, the relationship between the difficulty of operation and postoperative effects, and the relationship between the quality of operation and the prognosis still need to be further studied.

Citation： WANG Xiaodong, Lü Xinyi, LIU Jianbo, LI Li. Database research part Ⅶ: characteristics of colorectal cancer surgery (Ⅱ). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(11): 1418-1425. doi: 10.7507/1007-9424.202009095 Copy

1.	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.
2.	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.
3.	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.
4.	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.
5.	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.
6.	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.
7.	汪曉東, 林容若, 劉健博, 等. 數據庫建設第七部分: 結直腸癌手術特征的標簽與結構化 (二). 中國普外基礎與臨床雜志, 2020, 27(10): 1005-1010.
8.	汪曉東, 林容若, 劉健博, 等. 數據庫建設第七部分: 結直腸癌手術特征的標簽與結構化(一). 中國普外基礎與臨床雜志, 2020, 27(9): 1150-1156.
9.	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.
10.	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.
11.	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.
12.	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.
13.	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.
14.	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.
15.	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.
16.	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.
17.	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.
18.	汪曉東, 劉健博, 由屹先, 等. 數據庫研究第七部分: 結直腸癌手術的特征 (一). 中國普外基礎與臨床雜志, 2020, 27(8): 1005-1011.
19.	Hohenberger W, Weber K, Matzel K, et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation-technical notes and outcome. Colorectal Dis, 2009, 11(4): 354-364.
20.	姚宏偉, 張忠濤. 腹腔鏡直腸癌側方淋巴結清掃技術要點. 中國實用外科雜志, 2018, 38(10): 1148-1151.
21.	李立. 結直腸癌外科應用技術的規范與創新 (一). 中國普外基礎與臨床雜志, 2006, 13(1): 106-109.
22.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (三). 中國普外基礎與臨床雜志, 2008, 15(12): 941-942.
23.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (二). 中國普外基礎與臨床雜志, 2008, 15(11): 861-862.
24.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (一). 中國普外基礎與臨床雜志, 2008, 15(10): 778.
25.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (完). 中國普外基礎與臨床雜志, 2009, 16(4): 327-328.
26.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南(六). 中國普外基礎與臨床雜志, 2009, 16(3): 238-239.
27.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (五). 中國普外基礎與臨床雜志, 2009, 16(2): 162-163.
28.	李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (四). 中國普外基礎與臨床雜志, 2009, 16(1): 75-76.
29.	Laugesen MJ. The resource-based relative value scale and physician reimbursement policy. Chest, 2014, 146(5): 1413-1419.
30.	Boyle KM, Petty D, Chalmers AG, et al. MRI assessment of the bony pelvis may help predict resectability of rectal cancer. Colorectal Dis, 2005, 7(3): 232-240.
31.	程煌榮, 黎華麗, 黃曉東, 等. 內臟肥胖對結直腸癌根治手術操作及患者預后影響的關聯性分析. 中國臨床新醫學, 2020, 13(4): 349-354.
32.	Lohsiriwat V, Lohsiriwat D, Boonnuch W, et al. Outcomes of sphincter-saving operation for rectal cancer without protective stoma and pelvic drain, and risk factors for anastomotic leakage. Dig Surg, 2008, 25(3): 191-197.
33.	Rickles AS, Iannuzzi JC, Mironov O, et al. Visceral obesity and colorectal cancer: are we missing the boat with BMI? J Gastrointest Surg, 2013, 17(1): 133-143.
34.	Aquina CT, Rickles AS, Probst CP, et al. Visceral obesity, not elevated BMI, is strongly associated with incisional hernia after colorectal surgery. Dis Colon Rectum, 2015, 58(2): 220-227.
35.	Cakir H, Heus C, Verduin WM, et al. Visceral obesity, body mass index and risk of complications after colon cancer resection: A retrospective cohort study. Surgery, 2015, 157(5): 909-915.
36.	Heus C, Bakker N, Verduin WM, et al. Impact of body composition on surgical outcome in rectal cancer patients, a retrospective cohort study. World J Surg, 2019, 43(5): 1370-1376.
37.	Lee SY, Kim CH, Kim YJ, et al. Laparoscopic surgery for colorectal cancer patients who underwent previous abdominal surgery. Surg Endosc, 2016, 30(12): 5472-5480.
38.	Kim NK. Anatomic basis of sharp pelvic dissection for curative resection of rectal cancer. Yonsei Med J, 2005, 46(6): 737-749.
39.	Lange MM, van de Velde CJ. Urinary and sexual dysfunction after rectal cancer treatment. Nat Rev Urol, 2011, 8(1): 51-57.
40.	Tekkis PP, Prytherch DR, Kocher HM, et al. Development of a dedicated risk-adjustment scoring system for colorectal surgery (colorectal POSSUM). Br J Surg, 2004, 91(9): 1174-1182.
41.	Platell C, Barwood N, Dorfmann G, et al. The incidence of anastomotic leaks in patients undergoing colorectal surgery. Colorectal Dis, 2007, 1(1): 71-79.
42.	NCCN. The NCCN colon cancer clinical practice guidelines in oncology (version 3.2020). https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf.
43.	NCCN. The NCCN rectal cancer clinical practice guidelines in oncology (version 4.2020). https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf.

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 汪曉東, 林容若, 劉健博, 等. 數據庫建設第七部分: 結直腸癌手術特征的標簽與結構化 (二). 中國普外基礎與臨床雜志, 2020, 27(10): 1005-1010.
8. 汪曉東, 林容若, 劉健博, 等. 數據庫建設第七部分: 結直腸癌手術特征的標簽與結構化(一). 中國普外基礎與臨床雜志, 2020, 27(9): 1150-1156.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 汪曉東, 劉健博, 由屹先, 等. 數據庫研究第七部分: 結直腸癌手術的特征 (一). 中國普外基礎與臨床雜志, 2020, 27(8): 1005-1011.
19. Hohenberger W, Weber K, Matzel K, et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation-technical notes and outcome. Colorectal Dis, 2009, 11(4): 354-364.
20. 姚宏偉, 張忠濤. 腹腔鏡直腸癌側方淋巴結清掃技術要點. 中國實用外科雜志, 2018, 38(10): 1148-1151.
21. 李立. 結直腸癌外科應用技術的規范與創新 (一). 中國普外基礎與臨床雜志, 2006, 13(1): 106-109.
22. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (三). 中國普外基礎與臨床雜志, 2008, 15(12): 941-942.
23. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (二). 中國普外基礎與臨床雜志, 2008, 15(11): 861-862.
24. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (一). 中國普外基礎與臨床雜志, 2008, 15(10): 778.
25. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (完). 中國普外基礎與臨床雜志, 2009, 16(4): 327-328.
26. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南(六). 中國普外基礎與臨床雜志, 2009, 16(3): 238-239.
27. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (五). 中國普外基礎與臨床雜志, 2009, 16(2): 162-163.
28. 李立, 汪曉東, 舒曄, 等. 四川大學華西醫院·結直腸癌手術治療指南 (四). 中國普外基礎與臨床雜志, 2009, 16(1): 75-76.
29. Laugesen MJ. The resource-based relative value scale and physician reimbursement policy. Chest, 2014, 146(5): 1413-1419.
30. Boyle KM, Petty D, Chalmers AG, et al. MRI assessment of the bony pelvis may help predict resectability of rectal cancer. Colorectal Dis, 2005, 7(3): 232-240.
31. 程煌榮, 黎華麗, 黃曉東, 等. 內臟肥胖對結直腸癌根治手術操作及患者預后影響的關聯性分析. 中國臨床新醫學, 2020, 13(4): 349-354.
32. Lohsiriwat V, Lohsiriwat D, Boonnuch W, et al. Outcomes of sphincter-saving operation for rectal cancer without protective stoma and pelvic drain, and risk factors for anastomotic leakage. Dig Surg, 2008, 25(3): 191-197.
33. Rickles AS, Iannuzzi JC, Mironov O, et al. Visceral obesity and colorectal cancer: are we missing the boat with BMI? J Gastrointest Surg, 2013, 17(1): 133-143.
34. Aquina CT, Rickles AS, Probst CP, et al. Visceral obesity, not elevated BMI, is strongly associated with incisional hernia after colorectal surgery. Dis Colon Rectum, 2015, 58(2): 220-227.
35. Cakir H, Heus C, Verduin WM, et al. Visceral obesity, body mass index and risk of complications after colon cancer resection: A retrospective cohort study. Surgery, 2015, 157(5): 909-915.
36. Heus C, Bakker N, Verduin WM, et al. Impact of body composition on surgical outcome in rectal cancer patients, a retrospective cohort study. World J Surg, 2019, 43(5): 1370-1376.
37. Lee SY, Kim CH, Kim YJ, et al. Laparoscopic surgery for colorectal cancer patients who underwent previous abdominal surgery. Surg Endosc, 2016, 30(12): 5472-5480.
38. Kim NK. Anatomic basis of sharp pelvic dissection for curative resection of rectal cancer. Yonsei Med J, 2005, 46(6): 737-749.
39. Lange MM, van de Velde CJ. Urinary and sexual dysfunction after rectal cancer treatment. Nat Rev Urol, 2011, 8(1): 51-57.
40. Tekkis PP, Prytherch DR, Kocher HM, et al. Development of a dedicated risk-adjustment scoring system for colorectal surgery (colorectal POSSUM). Br J Surg, 2004, 91(9): 1174-1182.
41. Platell C, Barwood N, Dorfmann G, et al. The incidence of anastomotic leaks in patients undergoing colorectal surgery. Colorectal Dis, 2007, 1(1): 71-79.
42. NCCN. The NCCN colon cancer clinical practice guidelines in oncology (version 3.2020). https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf.
43. NCCN. The NCCN rectal cancer clinical practice guidelines in oncology (version 4.2020). https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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