中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (01): 93-99.DOI: 10.19538/j.cjps.issn1005-2208.2023.01.13

• 论著 • 上一篇    下一篇

中国结直肠癌手术病例登记数据库2022年度报告：一项全国性登记研究

姚宏伟1，李心翔2，崔    龙3，张    卫4，池    畔5，王自强6，石晋瑶1，揭志刚7，孙跃明8，卢    云9，韩方海10，何显力11，陶凯雄12，王    权13，王贵英14，王振宁15，李    海16，钱    群17，李乐平18，卫洪波19，李伟华20，房学东21，张忠涛1，代表中国结直肠癌手术病例登记数据库研究者团队   

  1. 1 首都医科大学附属北京友谊医院普通外科 国家消化系统疾病临床医学研究中心，北京100050；2 复旦大学附属肿瘤医院大肠外科，上海 200032； 3 上海交通大学医学院附属新华医院结直肠外科，上海 200092；4 海军军医大学附属长海医院肛肠外科，上海 200433；5 福建医科大学附属协和医院结直肠外科，福建福州 350001；6 四川大学华西医院胃肠外科，四川成都 610041；7 南昌大学第一附属医院普通外科，江西南昌 330006；8 南京医科大学第一附属医院结直肠外科，江苏南京210029；9 青岛大学附属医院黄岛院区胃肠外科，山东青岛 266000；10 中山大学孙逸仙纪念医院胃肠外科，广东广州 510120；11 空军军医大学唐都医院普外科，陕西西安 710038；12 华中科技大学同济医学院附属协和医院胃肠外科，湖北武汉 430022；13 吉林大学白求恩第一医院胃肠外科，吉林长春 130021；14  河北医科大学第四医院普通外科，河北石家庄 050011；15 中国医科大学附属第一医院胃肠外科，辽宁沈阳110001；16 宁夏医科大学总医院普通外科，宁夏银川 750004；17 武汉大学中南医院结直肠肛门外科，湖北武汉430071；18 山东省立医院胃肠外科，山东济南 250021；19 中山大学附属第三医院胃肠外科，广东广州510630；20 福建省立医院肿瘤外科，福建福州 350001；21 吉林大学中日联谊医院胃肠结直肠肛门外科，吉林长春130012
  • 出版日期:2023-01-01 发布日期:2023-01-19

  • Online:2023-01-01 Published:2023-01-19

摘要： 目的    汇总分析CCCD数据库自2018年3月建立以来的录入数据，对当前国内结直肠癌外科治疗现状进行阶段性总结，为国内结直肠癌外科治疗及进一步建设数据库提供依据。方法    在原有CCCD数据库框架内进一步优化数据登记流程，于2020年1月起对结直肠癌病人临床信息全面采用前瞻性填报登记以及系统升级，汇总数据库升级前/后的数据，进行标准化整理及比较分析，分析中国结直肠癌诊断及手术治疗效果。结果    共纳入73个中心的结直肠癌病例83063例，结直肠癌病人的肿瘤学诊断基线信息在数据库升级前/后无明显变化，直肠癌（57.6%）占比仍高于结肠癌(42.4%)，近90%的直肠癌位于中低位直肠。结直肠癌腹腔镜手术比例有所上升，数据库升级后的腹腔镜手术比例>80%。手术R0切除率有所下降（95.5%），而R2切除率有所升高（2.6%）。营养风险筛查评分2002（NRS2002）、CAPRINI评分、美国麻醉医师学会（ASA）评分、血红蛋白及白蛋白等指标的登记完整度在数据库升级后显著提高，直肠癌MRI检查及围术期治疗信息记录也更加全面。总体术后并发症率下降（10.1%），切口感染仍是最常见的术后并发症但发生率下降为1.7%，数据库升级后的术后并发症发生率为5.3%,且以吻合口漏最常见（发生率1.3%）。结论    通过前瞻性数据录入，数据登记质量明显提高，今后数据库建设的重点应为术后并发症规范化登记以及随访信息的完善。

关键词: 结直肠癌：中国结直肠外科大数据研究协作组：中国结直肠癌手术病例登记数据库：回顾性：前瞻性

Abstract: Annual report of Chinese Colorectal Cancer Surgery Database in 2022: A nationwide registry study        YAO Hong- wei*， LI Xin- xiang， CUI Long， et al. On Behalf on the Research Team of Chinese Colorectal Cancer Surgery Database (CCCD). *Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, ＆ National Clinical Research Center for Digestive Diseases, Beijing 100050, China
Corresponding author: ZHANG Zhong-tao, E- mail: zhangzht@ccmu.edu.cn
Abstract    Objective    Since the establishment of the China Colorectal Cancer Surgery Database (CCCD) in March 2018, clinical data of colorectal patients in China have been collected retrospectively and prospectively. Here, we aimed to analyze all collected data of CCCD and show a landscape of current status of nationwide colorectal cancer surgery in China. Methods    The registration process was further updated within the framework of the previous CCCD database, and the clinical information of colorectal cancer patients was prospectively registered since January 2020. The data before and after the database upgrade were summarized for comparative analysis to evaluate the diagnosis and surgical treatment of colorectal cancer in China. Results    A total of 83,063 colorectal cancer cases in 73 centers were enrolled, and distribution of the overall colorectal cancer patients showed no significant change in tumor baseline information after database upgrade, rectal cancer (57.6%) accounted for a higher proportion than colon cancer (42.4%), and nearly 90% of rectal cancer was medium or low. After upgrade of the database, the proportions of laparoscopic surgery for colorectal cancer has increased, with more than 80% patients accepted laparoscopic surgery. The R0 excision rate decreased (95.5%) while the R2 excision rate increased (2.6%). The completeness of registration of NRS2002 score, CAPRINI score, ASA score, hemoglobin and albumin were improved in prospective registration. MRI examination for rectal cancer and perioperative treatment information were also collected more comprehensively. The overall postoperative complication rate decreased (10.1%), incision infection remained the most common postoperative complication but the incidence decreased to 1.7%, the prospectively registered postoperative complication rate was only 5.3%, and anastomotic leakage was the most common, but the incidence was only 1.3%. Conclusion    Through prospective data collection, the quality of data registration has been significantly improved, and the focus of database construction in the future should be on standardized registration of postoperative complications, and improvement of follow-up information.

Key words: colorectal cancer, Chinese Task Force of Colorectal Big Data, Chinese Colorectal Cancer Surgery Database, retrospective, prospective