The Establishment And Application Of Administrative Database For Rectal Cancer

Objective To establish adminsistrative database and to evaluate the results of the rectal cancer surgical treatment retrospectively, to compare the outcomes between the open and laparoscopic procedures, farther try to set up an available quality control standard system. Methods There were 326 rectal cancer patients underwent different surgical procedures from January of 2000 to September of 2003 in our hospital, all data were collected into the SPSS 10.0 database that included demographic, symptomatic and physical examination data, pre-operative laboratory and imaging information, operative details, clinical pathological stages, in-hospital morbidity and mortality, post-operative follow up and quality of life. These data were processed and analyzed by the SPSS software to observe the effects of the different surgeons and different operative procedures (open and laparoscopic) on the clinical outcomes. Results Among the 326 cases, 140 cases underwent TME procedure (42.9%), 113 Miles operation (34.7%), 182 Dixon operation (55.8%), 18 Hartmann procedure (5.5%), 1 Bricker operation (0.3%), 4 local excision (1.2%) and 8 stoma (2.5%). Postoperative die was 2 (0.61%), complications occurred in 54 cases, the incidence was 16.7%, ranged from 8.3% to 25.0% among the different surgeons, especially the complications and QOL(quanlity of life ), there were significant differences between the professional gastrointestinal surgeon and non-professional surgeons. 90 patients underwent laparoscopic procedure, which performed by the same surgeon. Compared with the open group, there were no significant differences between the operative time (t =0.942, p =0.347), distance from distal excised margin to the tumor (t =0.647, p=0.518) and harvested lymph nodes(t=0.516, p=0.131). The blood loss (t=7.363, p<0.001) and transfusion(t=2.519, p=0.018) in laparoscopic group were remarkably less than those in open group, The recovery of bowel function (z=3.639, p<0.001) and ambulation (z=3.676, p<0.001) in laparoscopic group were much earlier than those in open group. In-hospital morbidity beween the two groups had no noticeable differences (x2=1.730, p=0.716). The mean follow-up was 23 months (l~44months), and local recurrence of tumor in the groups was 7.8 %. The one-year, two-year and three-year survival was 96.88%, 87.70% and 72.97%, respectively. The open versus laparoscopic group, the one-year, two-year, and three-year survival was 96.63%, 88.31%, 73.34% versus 97.53%, 86.15%, and 72.09%, respectively. Conclusion The multiple-parameter database of rectal cancer...