Abstract
BackgroundThe Japanese National Clinical Database (NCD) is a large‐scale, nationwide, web‐based data entry system that is linked to the surgical board certification system and covers almost all surgical cases carried out in Japan.AimTo evaluate outcomes according to the gastroenterological section of the NCD.MethodsThe 115 surgical procedures stipulated by the “Training Curriculum for Board‐Certified Surgeons in Gastroenterology” were registered from 2011 to 2017. The number of surgeries, preoperative comorbidities, and short‐term outcomes were compared between registration periods.ResultsIn total, 3 818 414 cases have been registered. More than 70% of all surgeries were carried out at certified institutions. The annual number of cases has been increasing year after year, and the aged population has also been increasing. Although the rates of preoperative comorbidities and postoperative complications have been increasing, the postoperative mortality rate has remained relatively low; in 2017, the 30‐day mortality rate was 1.0% among those who underwent esophagectomy, 0.7% among those who underwent distal gastrectomy, 1.1% among those who underwent total gastrectomy, 1.3% among those who underwent right hemicolectomy, 0.5% among those who underwent low anterior resection, 1.3% among those who underwent hepatectomy, and 1.3% among those who underwent pancreaticoduodenectomy. The annual rate of endoscopic surgery dramatically increased over 7 years between 2011 and 2017, especially for low anterior resection (29.5%‐62.6%) and esophagectomy (31.0%‐56.1%).ConclusionThis database is expected to ensure the quality of the board‐certification system and surgical outcomes in gastroenterological surgery.
Highlights
January 2011, covers records of ≥95% of the surgeries carried out by regular surgeons in Japan.[2]
30-day mortality may underestimate the true risk for death, and opersurgeons are required to carry out 450 or more gastroenterological ative mortality is recommended as a standard outcome measure after operations and gastroenterological surgical training for more than colorectal surgery
Annual changes in the number of surgeries according to the 115 selected gastrointestinal operative procedures
Summary
January 2011, covers records of ≥95% of the surgeries carried out by regular surgeons in Japan.[2]. In the gastrointestinal surgery section, all surgical cases are registem.[1] The NCD database project, which started recordkeeping in tered and require detailed input items for eight procedures. We clarified the number of surgical cases and the mortality rates related to the 115 selected gastrointestinal operative procedures. We clarified the changes over time in the number of surgical cases procedures can be recorded for each case in the NCD, the total and mortality rates related to the eight main operative procedures from number of surgeries in “Results of the 115 gastrointestinal surgical to 2016. We comparatively studied patient sex, age groups, procedures for board-certification system” is not the actual total institution groups, and percentage contribution of certified surgeons number of surgical cases. Annual changes in the number of surgeries according to the 115 selected gastrointestinal operative procedures (esophagus)
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