中国结直肠癌手术病例登记数据库2019年度报告：一项全国性登记研究

目的 介绍“中国结直肠癌手术病例登记数据库（CCCD）”的登记研究方法,通过对全国多中心现有结直肠癌手术病例资料进行回顾性及前瞻性的收集和分析,了解目前全国结直肠癌手术治疗现状,为进一步建设数据库提供依据。方法 依托中华医学会外科学分会结直肠外科学组成立“中国结直肠外科大数据研究协作组（C-CBD）”,设计并建立CCCD”,基于“真实世界研究”的理念,通过回顾性及前瞻性收集并分析自2018年3月至2019年10月,来自全国性、多中心登记录入CCCD的结直肠癌手术病例,进行标准化整理及统计学处理,分析中国结直肠癌诊断及手术治疗效果。结果 共计纳入来自全国61个中心的结直肠癌手术病例72650例,其中直肠癌占57.9%,结肠癌42.1%,术前临床TNM Ⅰ、Ⅱ、Ⅲ、Ⅳ期的比例分别为18.6%、42.5%、30.7%及8.2%;行腹腔镜手术占56.7%,开腹手术占43.3%,行D1、D2及D3淋巴结清扫比例分别为占2.1%、51%及46.4%;行R0、R1、R2手术切除等分别为96.2%、2.2%、1.6%;消化道重建方式以器械吻合为主（约占98%）,手工吻合仅占2%;术后最为常见的并发症为切口感染,总体发生率为3.2%;结直肠癌手术切除标本平均检出淋巴结15.9枚,直肠癌手术标本环周切缘阳性率为1.7%。结论 中国结直肠癌手术病例数量庞大,术后近期效果良好,但诊断及治疗的规范化仍然有待进一步提高,围手术期资料、随访资料的完整性亦有待进一步完善。

Annual report of Chinese Colorectal Cancer Surgery Database in 2019: A nationwide registry study

Annual report of Chinese Colorectal Cancer Surgery Database in 2019: 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
YAO Hong-wei, LI Xin-xiang, CUI Long, ZHANG Wei, WANG Zi-qiang, CHI Pan are the first authors who contributed equally to the article
Abstract Objective To introduce the registration research method of the Chinese Colorectal Cancer Surgery Database (CCCD). Retrospectively and prospectively collect and analyze existing multi-center colorectal cancer surgery case data in China, and understand the current status of nationwide colorectal cancer surgery. Methods Based on the Chinese Society of Colorectal Surgery, Chinese Task Force of Colorectal Surgwery Big Data (C-CBD)" was established, and a "Chinese Colorectal Cancer surgery database (CCCD) "registration database was set up. Based on the concept of "real world study", nationawide multi-center registration records of CCCD from March 2018 to October 2019, were standardized and statistically processed, to analyze the diagnosis and surgical treatment of colorectal cancer in China. Results This study included a total of 72,650 surgical cases of colorectal cancer from 61 centers across the country, of which 57.9% were rectal cancer and 42.1% were colon cancer. The preoperative clinical TNM staging-Ⅰ, Ⅱ, Ⅲ, and IV ratios were 18.6%, 42.5%, 30.7%, and 8.2%; laparoscopic surgery accounted for 56.7%, open surgery accounted for 43.3%. D1, D2, and D3 lymph node dissection rates accounted for 2.1%, 51%, and 46.4%, respectively; The surgical resection grades were 96.2% in R0, 2.2% in R1, and 1.6% in R2, respectively. The anastomosis of the digestive tract was mainly stapler anastomosis (about 98%), and manual anastomosis only accounted for 2%. The most common complication after surgery was incision infection, with the rate of 3.2%. The average number of lymph nodes detected in surgically resected specimens of colorectal cancer was 15.9. The positive rate of peripheral resection margins in surgical specimens of rectal cancer was 1.7%. Conclusion The number of cases of colorectal cancer surgery in China is huge, and the short-term postoperative results are good, but the standardization of diagnosis and treatment still needs to be further improved. And the integrity of perioperative data and follow-up data needs to be further improved.