Construction Of Integrated Query System For Data Of Laparoscope Operations And Clinical Effect

BackgroundLaparoscopic technology has been widely applied in abdominal surgery clinic inrecent ten years as a high technology, and now it has been applied to most surgicaltreatment of abdominal organs. The new surgeries continue to emerge with theinnovation of surgical instruments, accumulation of surgical experience and theexpansion of surgical indication. Comparing with the traditional surgery, laparoscopehas some advantages. First, the operations with laparoscope are really the minimallyinvasive operations which are fewer invasions, faster operative process, less pain andless recovery time. Second, stabbing holes in the abdominal wall are instead of theincision of abdominal. This method avoided hurting the muscle, blood vessel and thenerve in the abdominal wall. The method can't have the danger of the incisionalhernia and the weak abdominal wall, either. This method won't influence the sportfunction of abdomen because of the scarring of the muscle and won't influence theskin numbness by cutting the nerve of abdominal wall. Third, the little holes on theabdominal wall in the operations of laparoscope are so small (just only 3-10mm),dispersion and concealment that they don't influence beauty. Fourth, the infectionrate and the liquefied fat are lower in the operation of laparoscopc than the traditionalsurgical operation that they are almost not to be considered. Fifth, the operations oflaparoscope are disturbed organs smaller than the traditional surgical operation,proved stimulation, pollution of the air or the bacteria in the air. To the operation, theelectric coagulation and the electric excision are the mainly means. The blood vesselsare coagulated and cut in the operation. Comparing with traditional operation, the hemorrhage operations are more completed. The abdominal cavities were thoroughlywashed before the operations ended that it can keep the abdominal cavities clean.Through these operations, the intestinal function can be resumed quickly, that meansthe patients can eating food earlier. The earlier eating is great reducing the intestinaladhesion after operations. Sixth, the laparoscopic operations needn't quickly infusion,the urine is small than the traditional surgical operation. That means most of thepatients who operated by the laparoscope needn't the catheters. Seventh, thelaparoscopic operations usually are under the general anesthesia. Various monitoringdevices are used in the operations. These make the operations more safety than thetraditional surgical operations. Eighth, the patients who were operated by thelaparoscope can get out bed earlier, this make the families nurse the patients easily.Ninth, the videos of the operations were preserved. These videos can be extractingeasily if some controversies are appeared in medical disputes. This function increasesthe transparency of the medical action.But the data processing isn't suited the data collecting during the development ofthe laparoscopic technology. This status is already serious restrained the using oflaparoscope by the doctors and researchers. There have not a method which canhandle the information of the patients who accept the laparoscopic operationcompletely and systematically in our country. The researchers had to collect theinformation from the two different systems which is the electronic medical recordssystem and the laparoscope memory system. This process made collectinginformation difficult and easy to make the mistake. These entire are not conducive thedevelopment of the laparoscopic technology and wide application in the clinic.ObjectiveThe aims of this study are collecting the clinical information of the laparoscopicoperation in the ordinary surgeon of the Zhujiang hospital. Using this information, weacquire the data of the laparoscopic operations and establish the database of theintegrated query system for data of laparoscope by FoxPro. These seconddevelopment databases not only have the information of the patients in the hospital, but also have the inquiries and statistical functions. This way can finally realize thesurgeon operation information, and the way can also provide favorable conditions forsystematized and standardized of the laparoscopic operation.Methods1. Meterial: From 1994-2005, we've collected 726 the laparoscopic operation cases inZhujiang Hospital. 395 patients in all were male and 331 patients were female with amean age of 49.34(range 8-87). Among these patients, 504 patients were accepted thelaparoscopic cholecystectomy; 80 patients were accepted the laparoscopicappendectomy; 22 patients were accepted the laparoscopic enterolysis; 23 patientswere accepted the repair of hernia by laparoscope; 10 patients were accepted thelaparoscopic fenestration operation of hepatic cyst; 1 patient was accepted theincision and drainage of liver abscess by laparoscope; 4 patients were accepted thehemangioma enucleation by laparoscope, 16 patients were accepted the laparoscopichepatectomy for liver cancer; 6 patients were accepted the laparoscopic splenectomy;41 patients were accept the laparoscopic radical resection of colorectal carcinoma;19patients were accept the laparoscopic radical resection of rectal carcinoma. 26patients were accepted the operation by gasless laparoscopy,27 patients were acceptedthe operation by hand-assisted laparoscope,673 patients were accepted the completelaparoscopic operation.2. Methods:(1)Operation methods:①anesthesia methods: General anesthesias or epidural anesthesia were performed inthe operation.②)operative instruments:Ⅰ:The equipment for the operation:The gasless laparoscope: The gasless equipment which used in the operation isdeveloped by Zhujiang hospital in 1995. We named this equipment Mechanical Fan-shaped Suspension Abdominal Equipment. The carbon dioxidepneumoperitoneum laparoscopic operations were operated by the equipment whichwas produced by the Olympus Company. The carbon pressure threshold is from thefourteen millimeters of mercury to the fifteen millimeters of mercury. Thehand-assisted equipment of laparoscope (HAL) is made from the JnjmedicalCompany of the United States which is called Hand-port or Lap-disc.Ⅱ:Operative instruments: The operation is completed by gasless or Carbon dioxidepneumoperitoneum, hand-assisted or complete laparoscope.(2)The methods of software design:①Date collection (information reserves): Through consult medical record, wedetermine to collected all of the laparoscopic operation cases in Zhujiang Hospitalfrom 1994-2005 as the research material.②We established the table form data set with the Microsoft Excel 2003 by the fieldpatients' ID, patients' names, patients' sex, the patients' ages, the time of get inhospital, the department of get in hospital, diagnosis, the date of operation, anesthesiamethods, the duration of operation, conversions to open surgery or not, quantity ofbleeding in operation, the date of exhaust after the operation, the date of get of bed,the days of hospitalized, the expense of operation, the total expense of hospitalized.③The database is constructed with these field by the database design softwareFoxPro(development once more):The coding of the FoxPro database: we coded the database with the field by thesoftware Microsoft Visual FoxPro 8.0 which own the construction system and buildthe preliminary database with the data of all of the information for the laparoscopicpatients from May 1994 to May 2005. The information which we collected was inputinto the database to test the procedure. According to result which tests, we havecarried on the debugging to the procedure, finally has established the integrated querysystem for data of Laparoscope operation.④Database usability observation target: System compatibility, System stability,System usability, System maintainability, system expendability e.g. Results1. We established the table form data set for the laparoscopic operation with theMicrosoft Excel 2003; this data set can satisfy the flow request:①The table form comes from the clinical cases, recording the information of thelaparoscopic operation in detail.②The excel table form data can import the FoxPro database directly and programmedby the FoxPro.③The excel table form data can contrast with the second development FoxProdatabase. Because of the Excel's searching and statistical functions, we can comparethe excel table form data with the second development FoxPro database, testingwhether the second development FoxPro database function well.2. We have designed the fields of the database successfully. This database cansearch, dual search or accuracy the data through the choice of the database fields. Theresults of searching are not only details revealed by the dialog, but also revealed bythe tabular form. This searching can statistic the data of the operation, calculated ofaverage or standard deviation.3. Confirmation of the database system:①We confirmed the correct of the programs for the system by the dynamic test andthe static test;②We confirmed the correct of the function of the system by search the data by thesystem and comprised to the excel, this is certified the correct of the function of thesystem.4. The clinical effect of the database system: We carried on the classified statisticsto the field which was conformed on the requirement. By these statistics, we obtainedthe statistical information of the observation target for the laparoscopic operationsand the other information of the special laparoscopic cases.ConclusionThe integrated query system for data of laparoscopic operations based on FoxPro isthe union product of the FoxPro system and the modern medical technology. The system provided a platform for the data inquiry of the laparoscopic operations whichmakes the complex inquiry process simply and easy to summary or analysis. Thesoftware has the functions as below:①This database is the professional database for the laparoscopic operation, which isbased upon the aggregation of the characteristics of the laparoscopic operation andthe analysis of the record. The field of the database accords with the characteristics ofthe laparoscopic profession and includes all of the information of the patients. Thesystem's source code can be modified according the using and have the room for thedata improvement.②The integrated query system for data of laparoscope operations is the products ofthe computer database technology and the clinical medical technology, and this is theproducts of the Cross-cutting and interdisciplinary researching. This technology isadapted the modern medical information management and information technologydevelopment requirements③The user can manage the data of the laparoscopic operations in the databasethrough the senior searching function. This function can make the user find theinformation by searching with single or double conditions, statistics the data, whichcan avoid deficiencies of manual inquiries and make the data true and reliable.④The system have the choice of the manager. The manager can managed theinformation in the database and give the authority to the user, this make theinformation in the database safety. The system can install into the doctors'workstation, the doctors can use the information in the database to study and researcheasily.⑤The system's operation is simple, convenient, easy to study and master. Thesystem can use the information conveniently and quickly, search the informationquickly, visit the information of the patients, the statistics data of the patients canoutput and used by the familiar way. ⑥The system collected the information of all the laparoscopic operations, reflectingthe treatment more comprehensively, comparing the excellence and the deficiency ofthe operations, analyzing the dangers or the reasons of the conversion to open andthe reason of complications. All of these can guide to the decision of treatment.⑦This system can easily be changed into another medical database by changing thefield. It can be used as storing the data, analyzing and researching the information ofthe clinical cases, which increase the uses of the system.