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.	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.
2.	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.
3.	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.
4.	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.
5.	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.
6.	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.
7.	汪晓东, 林容若, 刘健博, 等. 数据库建设第七部分: 结直肠癌手术特征的标签与结构化 (二). 中国普外基础与临床杂志, 2020, 27(10): 1005-1010.
8.	汪晓东, 林容若, 刘健博, 等. 数据库建设第七部分: 结直肠癌手术特征的标签与结构化(一). 中国普外基础与临床杂志, 2020, 27(9): 1150-1156.
9.	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.
10.	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.
11.	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.
12.	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.
13.	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.
14.	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.
15.	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.
16.	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.
17.	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.
18.	汪晓东, 刘健博, 由屹先, 等. 数据库研究第七部分: 结直肠癌手术的特征 (一). 中国普外基础与临床杂志, 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.	姚宏伟, 张忠涛. 腹腔镜直肠癌侧方淋巴结清扫技术要点. 中国实用外科杂志, 2018, 38(10): 1148-1151.
21.	李立. 结直肠癌外科应用技术的规范与创新 (一). 中国普外基础与临床杂志, 2006, 13(1): 106-109.
22.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (三). 中国普外基础与临床杂志, 2008, 15(12): 941-942.
23.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (二). 中国普外基础与临床杂志, 2008, 15(11): 861-862.
24.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (一). 中国普外基础与临床杂志, 2008, 15(10): 778.
25.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (完). 中国普外基础与临床杂志, 2009, 16(4): 327-328.
26.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南(六). 中国普外基础与临床杂志, 2009, 16(3): 238-239.
27.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (五). 中国普外基础与临床杂志, 2009, 16(2): 162-163.
28.	李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (四). 中国普外基础与临床杂志, 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.	程煌荣, 黎华丽, 黄晓东, 等. 内脏肥胖对结直肠癌根治手术操作及患者预后影响的关联性分析. 中国临床新医学, 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. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 汪晓东, 林容若, 刘健博, 等. 数据库建设第七部分: 结直肠癌手术特征的标签与结构化 (二). 中国普外基础与临床杂志, 2020, 27(10): 1005-1010.
8. 汪晓东, 林容若, 刘健博, 等. 数据库建设第七部分: 结直肠癌手术特征的标签与结构化(一). 中国普外基础与临床杂志, 2020, 27(9): 1150-1156.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. 汪晓东, 刘健博, 由屹先, 等. 数据库研究第七部分: 结直肠癌手术的特征 (一). 中国普外基础与临床杂志, 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. 姚宏伟, 张忠涛. 腹腔镜直肠癌侧方淋巴结清扫技术要点. 中国实用外科杂志, 2018, 38(10): 1148-1151.
21. 李立. 结直肠癌外科应用技术的规范与创新 (一). 中国普外基础与临床杂志, 2006, 13(1): 106-109.
22. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (三). 中国普外基础与临床杂志, 2008, 15(12): 941-942.
23. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (二). 中国普外基础与临床杂志, 2008, 15(11): 861-862.
24. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (一). 中国普外基础与临床杂志, 2008, 15(10): 778.
25. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (完). 中国普外基础与临床杂志, 2009, 16(4): 327-328.
26. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南(六). 中国普外基础与临床杂志, 2009, 16(3): 238-239.
27. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (五). 中国普外基础与临床杂志, 2009, 16(2): 162-163.
28. 李立, 汪晓东, 舒晔, 等. 四川大学华西医院·结直肠癌手术治疗指南 (四). 中国普外基础与临床杂志, 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. 程煌荣, 黎华丽, 黄晓东, 等. 内脏肥胖对结直肠癌根治手术操作及患者预后影响的关联性分析. 中国临床新医学, 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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Database research part Ⅶ: characteristics of colorectal cancer surgery (Ⅱ)

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