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胃癌手术质量控制数据的公布推动胃癌手术水平的提高:基于2020—2022年江苏省胃癌质量控制数据分析

The publication of quality control data for gastric cancer surgery promotes the improvement of gastric cancer surgery level: based on the analysis of quality control data for gastric cancer in Jiangsu Province, 2020-2022

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【作者】 王林俊夏义文李铮李清雅张殿彩徐皓杨力宋军管文贤徐泽宽

【Author】 WANG Linjun;XIA Yiwen;LI Zheng;LI Qingya;ZHANG Diancai;XU Hao;YANG Li;SONG Jun;GUAN Wenxian;XU Zekuan;Gastric Cancer Center, The First Affiliated Hospital of Nanjing Medical University;Department of General Surgery, Affiliated Hospital of Xuzhou Medical University;Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School;

【通讯作者】 徐泽宽;

【机构】 南京医科大学第一附属医院胃肿瘤中心徐州医科大学附属医院普通外科南京大学医学院附属鼓楼医院胃肠外科

【摘要】 目的:收集并分析2020—2022年江苏省胃癌手术质量控制的相关数据,研究胃癌手术质量控制数据的公布在推动中国胃癌手术水平提升中的作用。方法:以江苏胃癌联盟(Jiangsu Gastric Cancer Union,JSGCU)为平台,采用调查问卷的形式,在线创建相关问卷后,由各联盟成员单位根据要求在线填写相关问卷内容。收集资料内容包括:医院基本情况、早期胃癌诊治、局部进展期胃癌诊治、晚期胃癌诊治、消化道重建、手术安全性以及经济学指标等。结果:连续收集并分析了2020—2022年江苏省胃癌手术质量控制的相关数据。数据分析结果显示,2020—2022年Ⅰ期胃癌患者的比例逐年上升,胃癌早筛、早诊、早治工作的成果得到了很好的体现;腹腔镜手术率逐年上升,已成为江苏省胃癌根治术的主流方式;胃癌淋巴结清扫数目≥30枚的医院比例逐年上升;不同部位的胃癌根治术后消化道重建方式的选择各有特点;胃癌腹腔镜手术Ⅲ级以上并发症的发生率略低于开放性手术,其中发生并发症患者的术后住院时间明显延长,术后住院费用也明显提高。胃癌手术中选择关闭系膜间隙的医院比例逐年上升。结论:江苏省胃癌手术质量控制数据的公布推动了中国胃癌手术水平的提高。

【Abstract】 Objective: To collect and analyze the quality control data of gastric cancer surgery in Jiangsu Province from 2020 to 2022, and study the role of publishing surgical quality control data in promoting the improvement of gastric cancer surgery of China.Methods: An online questionnaire was created and distributed to the members of Jiangsu Gastric Cancer Union(JSGCU). The questionnaire collected information including the basic situation of hospital, the diagnosis and treatment of early gastric cancer, advanced gastric cancer and metastatic gastric cancer, the digestive tract reconstruction, the surgical safety,the economic indicators, and so on.Results: The quality control data of gastric cancer surgery in Jiangsu Province from 2020 to 2022 were consistently collected and published. The data analysis results show that there was a gradual increase in the percent of patients with stage Ⅰ gastric cancer, reflecting the success efforts of early screening and diagnosis. Laparoscopic surgery showed a steady increase and became the mainstream approach for curative surgery of gastric cancer in Jiangsu Province. The percent of hospital with lymph node dissection ≥30 was also increased. Different locations of gastric cancer exhibited specific patterns in the choice of anastomosis methods after curative surgery. The rate of grade 3 or higher complications in laparoscopic gastric cancer surgery was slightly lower than that in open surgery. For patients experiencing complications, their postoperative hospitalization duration and expenditure were significantly higher. Finally, there was a gradual increase in the proportion of hospital choosing to close the mesentery during gastric cancer surgery.Conclusion: The publication of the quality control data of gastric cancer surgery in Jiangsu Province has driven the improvement of gastric cancer surgery standards of China.

【关键词】 胃癌手术质量控制手术质量
【Key words】 Gastric cancerSurgeryQuality controlSurgical quality
【基金】 中国国家科学技术基础研究专项基金(2019FY101104);国家自然科学基金(82072708,82273038);江苏省科教能力提升工程,江苏省医学重点学科(ZDXK202222);南京医科大学第一附属医院创新研究项目,江苏省高等教育机构重点学科建设项目(JX10231801);江苏省333工程(BRA2015474)~~
  • 【分类号】R735.2
  • 【下载频次】8
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