Database research part <b>Ⅷ</b>: postoperative risks and complications of colorectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Xiaodong ¹ , MENG Xinyu ^1,2 , LIU Jianbo ^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; postoperative complication; medical quality

DOI：

10.7507/1007-9424.202101025

Video：

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Objective To analyze the risks and complications after operation of colorectal cancer 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 28th, 2020. The data items included surgery reaction, body temperature, flatus, pain and mental status; preoperative complication, postoperative complication, short-term and long-term complication. The selected data items were statistically analyzed.Results The total number of medical records (data rows) that met the criteria was 6 422, including 4 185 (65.2%) valid data on surgery reaction, 3 833 (59.7%) valid data on body temperature, 3 835 (59.7%) valid data on flatus, 3 597 (56.0%) valid data on pain, 3 551 (55.3%) valid data on mental status, 6 422 (100%) valid data on preoperative complications, postoperative complications, short-term complications and long-term complications. In the surgical response, 1 517 (36.2%) lines of data showed “normal” structure were the most. Among the days with elevated body temperature, the number of 0-day data lines with the structure of “body temperature >37.5 ℃” was the highest, with 1 980 (51.7%). In postoperative flatus, there were 1 675 (43.7%) data lines with the structure showing “3 days”. The largest number of rows (2 755, 76.6%) showed a structure that was “not obvious” in the pain scale. The mental status showed the highest number of “better” rows (2 976, 83.8%). There were 50 preoperative complications (0.8%). And 595 postoperative complications (9.3%), including anastomotic leakage (80, 13.4%), inflammatory ileus (62, 10.4%), pulmonary infection (57, 9.6%), and anastomotic bleeding (56, 9.4%), etc. There were 6 169 (96.1%) without short-term complication in structural form. There were 6 283 (97.8%) without long-term complications.Conclusions The changes in complications shown in the real world data from DACCA suggest that the focus of postoperative risks must be changed with the over the follow-up time. As for the complication evaluation system, it is necessary to establish a complete evaluation system combining the corresponding types and risks, to carry out valuable complication researches.

Citation： WANG Xiaodong, MENG Xinyu, LIU Jianbo, LI Li. Database research part Ⅷ: postoperative risks and complications of colorectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(3): 369-375. doi: 10.7507/1007-9424.202101025 Copy

1.	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.
2.	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.
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9.	Lovich-Sapola J, Smith CE, Brandt CP. Postoperative pain control. Surg Clin North Am, 2015, 95(2): 301-318.
10.	Bolliger M, Kroehnert JA, Molineus F, et al. Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg, 2018, 50(6): 256-261.
11.	de la Portilla F, Builes S, García-Novoa A, et al. Analysis of quality indicators for Colorectal Cancer Surgery in Units Accredited by the Spanish Association of Coloproctology. Cir Esp, 2018, 96(4): 226-233.
12.	Sparreboom CL, van Groningen JT, Lingsma HF, et al. Different risk factors for early and late colorectal anastomotic leakage in a nationwide audit. Dis Colon Rectum, 2018, 61(11): 1258-1266.
13.	顏登國, 張汝一, 甄運寰, 等. 結直腸癌切除術后吻合口瘺的治療. 中華胃腸外科雜志, 2006, 9(5): 408.
14.	柯海林, 池畔, 林惠銘, 等. 直腸癌術后吻合口瘺對長期預后的影響. 中華胃腸外科雜志, 2015, 18(9): 920-924.
15.	鄭暉, 池畔, 林惠銘, 等. 結直腸癌術后手術部位切口感染的預后因素分析. 中華外科雜志, 2016, 54(6): 424-428.
16.	任立煥, 傅衛, 王亮, 等. 結直腸癌患者圍手術期并發癥和病死率的研究. 中華普通外科雜志, 2007, 22(1): 3-7.
17.	Artinyan A, Orcutt ST, Anaya DA, et al. Infectious postoperative complications decrease long-term survival in patients undergoing curative surgery for colorectal cancer: a study of 12, 075 patients. Ann Surg, 2015, 261(3): 497-505.
18.	汪曉東, 方智, 李姣, 等. POSSUM 評分系統在外科手術中的應用現狀. 重慶醫學, 2008, 37(15): 1747-1749.

1. 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.
2. 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.
3. Cavallaro P, Bordeianou L. Implementation of an ERAS pathway in colorectal surgery. Clin Colon Rectal Surg, 2019, 32(2): 102-108.
4. Renz BW, Kasparek MS, Seeliger H, et al. The CR-POSSUM risk calculator predicts failure of enhanced recovery after colorectal surgery. Acta Chir Belg, 2015, 115(1): 20-26.
5. 馮金華, 黃明君, 胡艷杰, 等. 加速康復對結直腸癌患者術后炎性指標和免疫功能影響的研究進展. 重慶醫學, 2015, 44(4): 548-551.
6. Read TE, Brozovich M, Andujar JE, et al. Bowel sounds are not associated with flatus, bowel movement, or tolerance of oral intake in patients after major abdominal surgery. Dis Colon Rectum, 2017, 60(6): 608-613.
7. Hawker GA, Mian S, Kendzerska T, et al. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res (Hoboken), 2011, 63 Suppl 11: S240-S252.
8. 陳凜, 陳亞進, 董海龍, 等. 加速康復外科中國專家共識及路徑管理指南(2018 版). 中國實用外科雜志, 2018, 38(1): 1-20.
9. Lovich-Sapola J, Smith CE, Brandt CP. Postoperative pain control. Surg Clin North Am, 2015, 95(2): 301-318.
10. Bolliger M, Kroehnert JA, Molineus F, et al. Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg, 2018, 50(6): 256-261.
11. de la Portilla F, Builes S, García-Novoa A, et al. Analysis of quality indicators for Colorectal Cancer Surgery in Units Accredited by the Spanish Association of Coloproctology. Cir Esp, 2018, 96(4): 226-233.
12. Sparreboom CL, van Groningen JT, Lingsma HF, et al. Different risk factors for early and late colorectal anastomotic leakage in a nationwide audit. Dis Colon Rectum, 2018, 61(11): 1258-1266.
13. 顏登國, 張汝一, 甄運寰, 等. 結直腸癌切除術后吻合口瘺的治療. 中華胃腸外科雜志, 2006, 9(5): 408.
14. 柯海林, 池畔, 林惠銘, 等. 直腸癌術后吻合口瘺對長期預后的影響. 中華胃腸外科雜志, 2015, 18(9): 920-924.
15. 鄭暉, 池畔, 林惠銘, 等. 結直腸癌術后手術部位切口感染的預后因素分析. 中華外科雜志, 2016, 54(6): 424-428.
16. 任立煥, 傅衛, 王亮, 等. 結直腸癌患者圍手術期并發癥和病死率的研究. 中華普通外科雜志, 2007, 22(1): 3-7.
17. Artinyan A, Orcutt ST, Anaya DA, et al. Infectious postoperative complications decrease long-term survival in patients undergoing curative surgery for colorectal cancer: a study of 12, 075 patients. Ann Surg, 2015, 261(3): 497-505.
18. 汪曉東, 方智, 李姣, 等. POSSUM 評分系統在外科手術中的應用現狀. 重慶醫學, 2008, 37(15): 1747-1749.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Database research part Ⅷ: postoperative risks and complications of colorectal cancer

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