摘要
目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中结直肠癌手术的特征。方法本次数据分析选取的DACCA版本为2020年4月16日更新版,其中数据项目包括时机、手术名称、手术性质、保肛、造口、还瘘日期、手术路径、扩大切除和经括约肌间切除术(ISR)类型,增设数据项目包括还瘘间隔,对所选的数据项目进行统计学分析。结果本研究符合筛选条件的数据病案(数据行)总量为11 757条,其中手术时机的有效数据共2 729条(23.2%),手术名称的有效数据共11 389条(96.9%),手术性质的有效数据共4 255条(36.2%),保肛的有效数据共3 803条(32.3%),造口的有效数据共4 377条(37.2%),还瘘日期的有效数据共989条(8.4%),手术路径的有效数据共4 418条(37.6%),扩大切除的有效数据共3 941条(33.5%)、ISR类型的有效数据共1 156条(9.8%)。手术时机中,发现后及时或新辅助完成后立刻手术占比最多(915条,占33.5%)。手术名称中超低位前切除术(ULAR)、右半结肠切除术(RHC)和低位前切除术(LAR)条数在前3位,分别有1 986(17.4%)、1 412(12.4%)和1 041条(9.1%),且在结肠癌手术和直肠癌手术中,RHC(50.0%)与ULAR(26.0%)分别占比最高,扩大切除分别有172条(26.1%)和815条(27.9%)。ISR手术中以ISR-2居多(741条,占64.1%)。手术性质中R0数据行数最多,共2 575条(60.5%)。保肛中积极和理性的数据行数最多,分别有1 811条(47.6%)和1 440条(37.9%)。造口中未造口的有2 628条(60.0%),有造口的有1 749条(40.0%),其中以回肠右下腹造口术最多(612条,占35.0%)。还瘘间隔的最小值为0 d,最大值2 678 d,中位数为112 d,还瘘时间随年份变化的趋势不明显(P=0.07)。在手术路径中,结构化显示为标准的数据行占绝大多数(72.0%),共3 182条。结论在DACCA数据库中,直肠癌手术仍然是最主要的外科手术,并且超低位手术是最主要的类型;扩大手术的应用无论是对结肠癌还是对直肠癌都具�
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 16 th, 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
作者
汪晓东
刘健博
由屹先
李立
WANG Xiaodong;LIU Jianbo;YOU Yixian;LI Li(Department of Gastrointestinal Surgery,West China Hospital of Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu 610041,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2020年第8期1005-1011,共7页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省科技厅项目(项目编号:2019YFS0291)。
关键词
结直肠癌
数据库
大数据
手术类型
肠造口
医疗质量
colorectal cancer
database
big data
type of operation
enterostomy
medical quality
