Objective To analyze the data of external fixation instruments (including Ilizarov instruments) used by QIN Sihe orthopaedic surgical team in the treatment of limb deformities in the past 30 years, and to explore the indications for the application of modern external fixation techniques in the correction of limb deformities and individual device configuration selection strategy. Methods According to QIN Sihe orthopaedic surgical team, the use of external fixator between January 1988 and December 2017 was analyzed retrospectively. The total use of external fixation and the proportion of different external fixators were analyzed in gender, different operation time, different age, different parts, and different diseases. Results External fixators were used in 8 113 patients, 69 of them were used simultaneously in both lower extremity surgery, so 8 182 external fixators were used. Among them, there were 4 725 (57.74%) combined external fixators, 3 388 (41.41%) Ilizarov circle fixators, 64 (0.78%) single arm external fixators (including Orthofix), 5 (0.06%) Taylor space external fixators. There were 4 487 males (55.31%) and 3 626 females (44.69%). According to the analysis of different time periods, the number of external fixators increased year by year, and the number of applications increased after 2000. The main age of the patients was 11-30 years old, of which 1 819 sets (22.23%) were used at the age of 21-25 years. The use of the external fixator covered almost all parts of the limbs, with the ankle and toe areas being the most common, reaching 4 664 sets (57.00%), and the upper extremities the least, with 152 sets (1.86%). The 8 113 cases covered more than a dozen disciplines and more than 150 kinds of diseases. The top 5 diseases were poliomyelitis sequelae, cerebral palsy, deformity of lower extremity after spina bifida, traumatic sequelae, and congenital equinovarus foot. Conclusion Ilizarov technique has been widely used in extremity deformity, disability, and complicated orthopedic diseases caused by vascular, lymphoid, nerve, skin, endocrine, and other diseases. The indication of operation is far beyond the scope of orthopedics. The domestic external fixator and its mounting tools can basically meet the requirements of various treatments. The technique of external fixation has entered a new era of tension tissue regeneration under stress control, natural repair of tissue trauma and deformity, and reconstruction of limb function.
ObjectiveTo explain surgical and medical comorbidities and preoperative physical status of colorectal cancer in detail as well as their tags and structures of Database from Colorectal Cancer (DACCA) in West China Hospital.MethodThe article was described in words.ResultsThe definition to the surgical comorbidities with its related content module, the medical comorbidity with its related content modules, and the preoperative physical status and characteristics of the DACCA in West China Hospital were given. The data label corresponding to each item in the database and the structured way needed for the big data application stage in detail were explained. And the error correction notes for all classification items were described.ConclusionsThrough the detailed description of the medical and surgical comorbidities and the preoperative physical status of DACCA in West China Hospital, it provides the standard and basis for the clinical application of DACCA in the future, and provides reference for other peers who wish to build a colorectal cancer database.
ObjectiveTo investigate the characteristics and corrective strategies of various limb deformities treated by QIN Sihe orthopaedic team in the past 40 years, so as to provide a large sample for understanding the causes, types, and treatment methods of limb deformity and disability in China.MethodsA clinical data of 35 075 cases who were treated by QIN Sihe orthopaedic team between May 1978 and December 2018 was summarized. The age, gender, deformity characteristics, etiological and pathological composition, regional distribution, and surgical methods of the patients were analyzed.ResultsThere were 20 458 males (58.33%) and 14 617 females (41.67%). The age ranged from 1 to 82 years (mean, 20.5 years). The majority people (19 363 cases, 55.20%) were 11-25 years old. Of which, 33 259 cases (94.82%) were operated on lower extremity. The geographical distribution of patients covered 33 regions in China and 12 foreign countries. There were 202 etiologies involved neurological, heredity, metabolism, traumatic sequelae, congenital, vascular, lymphoid, skin, endocrine, iatrogenic, and so on. The disease covered all subsubjects of orthopaedics. The top six deformities secondary to poliomyelitis sequelae, cerebral palsy, traumatic sequelae, spondylolysis sequelae, genu varum and genu valgum, and congenital talipes equinovarus. There were 280 kinds of surgical methods, the majority of which were Achilles tendon lengthening, supracondylar osteotomy, subtalar joint arthrodesis, tibiofibular osteotomy, metatarsal aponeurosis, and Achilles tendon replacement of peroneal longus muscle, etc. Orthopaedic surgery combined with external fixation were applied in 8 702 cases, including Ilizarov fixator in 3 696 cases and Hybrid fixator in 5 006 cases.ConclusionQIN Sihe orthopaedic database with 40 years is the largest one of limb deformity and disability in China. It reflects the etiology, type, population characteristics, surgical methods and strategy of limb disability and deformity which can be treated by orthopaedic surgery. The data needs to be further excavated and deeply studied in future because of its important academic value and historical significance.
ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on September 26, 2019. The data items included: date of surgery, precancerous lesions, cancer family, tumor site, distance to the dentate line, morphology of tumor, size, position, happening and origination, differentiation, pathology of tumor, Ki-67 of protein, complications (included obstruction, intussusception, perforation, pain, edema, and hemorrhage) were analyzed for the characteristics of each selected data item.ResultsA total of 11 898 analyzable data rows were obtained by screening the DACCA database. Among the 11 898 pieces of data, the effective data of precancerous lesions was 1 275, including 541 (42.4%) with precancerous lesions, and 734 (57.6%) without precancerous lesions. There were 1 116 valid data on cancer families, and 761 (6.4%) had a family history of cancer. The Ki-67 index had a total of 1 893 valid data, which ranged form 0 to 95% [(59.0±20.1) %]. According to the classification of tumor occurrence, the primary colorectal cancer accounted for the vast majority (92.8%), and the metastatic colorectal cancer was the least (0.3%). According to the primary and multiple primary, respectively analysis of tumor site, distance to the dentate line, morphology of tumor, size, position, differentiation, and pathology of tumor showed that, most tumor’s position were in the rectum (76.9%, 41.9%), the most common morphology was ulcers (42.4%, 51.5%), the most tumors were located around the wall of intestine (44.6%, 35.0%), the degree of differentiation was mostly moderate (65.4%, 61.3%), most of the tumor pathologies were adenocarcinoma (77.8%, 64.0%).ConclusionA more accurate and detailed analysis of colorectal cancer tumor characteristics by the DACCA database is helpful for determining the diagnosis and treatment plan in clinical work, judging the prognosis, and so on.
ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on April 16th, 2020. The data items included timing of operation, types of operative procedure, radical resection level of operation, patient’s wish of anus-reserving, types of stomy, date of stoma closure, surgical approaches, extended resection, and type of intersphincteric resection (ISR). The data item interval of stoma closure was added, and the selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 11 757, including 2 729 valid data on the timing of operation (23.2%), 11 389 valid data on the types of operative procedure (96.9%), 4 255 valid data on the radical resection level of operation (36.2%), 3 803 valid data on patient’s wish of anus-reserving (32.3%), 4 377 valid data on types of stomy (37.2%), 989 valid data on date of stoma closure (8.4%), 4 418 valid data on surgical approaches (37.6%), 3 941 valid data on extended resection (33.5%), and 1 156 valid data on type of ISR (9.8%). In the timing of operation, the most cases were performed immediately after discovery or neoadjuvant completion (915, 33.5%). In types of operative procedure, ultra low anterior resection (ULAR), right hemicolectomy (RHC), and low anterior resection (LAR) were the most, including 1 986 (17.4%), 1 412 (12.4%), and 1 041 (9.1%) lines. Respectively in the colon and rectal cancer surgery, the proportion of RHC (50.0%) and ULAR (26.0%) was the highest, with 172 (26.1%) and 815 (27.9%) extended resection. In ISR surgery the majority was ISR-2 (741, 64.1%). In radical resection level of operation, the number of R0 was the largest with 2 575 (60.5%) lines. In patient’s wish of anus-reserving, positive and rational were the most with 1 811 (47.6%) and 1 440 (37.9%) lines, respectively. And in types of stomy, there were 2 628 lines (60.0%) without stoma and 1 749 cases (40.0%) with stoma, among which the most lines were right lower ileum stoma (612, 35.0%). The minimum value, maximum value, and median value of interval of stoma closure were 0 d, 2 678 d and 112 d. The linear regression prediction of date of stoma closure by year was \begin{document}${\hat {y}} $\end{document}=9.234 3x+22.394 (R2=0.2928, P=0.07). In the surgical approaches, the majority was standard with 3 182 (72.0%) lines.ConclusionsIn the DACCA, rectal cancer surgery is still the majority, and ULAR is the most type. The application of extended resection in both colon and rectal cancer has important significance. The data related to stoma are diversified and need to be further studied.
ObjectiveTo describe the characteristics of colorectal cancer surgical procedures in the West China Colorectal Cancer Database (Database from Colorectal Cancer, DACCA).MethodWe used the form of text description.ResultsThe related content modules of DACCA operation in West China, included operative type, radical resection level, anus preservation, stoma type, the date of closure, surgical approach, expansive resection, intersphincteric resection (ISR), etc. were elaborated. The data label related method corresponding to each item in the database and the structured method required in the corresponding big data application stage were elaborated, and the error correction precautions of all classified items were described.ConclusionsIn the DACCA database, there are more detailed classification for the radical treatment of colorectal cancer. The application of expanded surgery is of great significance for both colon cancer and rectal cancer; stoma-related data has diversified data characteristics, which will provides standards and basis for clinical application of DACCA, and also provides experience reference for other colleagues who want to build colorectal cancer database.
ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on July 16th, 2020. The data items included operative duration, anatomy (anatomical difficulty), pelvis (pelvic stenosis), obesity (abdominal obesity), adhesion (adhesion in surgical area), mesentery (abnormal mesenteric status), hypertrophy (tissue hypertrophy or organ hypertrophy), intestinal quality, death (risk of death), injury (risk of tissue injury), recurrence (tumor recurrence), metastasis (tumor metastasis), anastomotic leakage (risk of anastomotic leakage), difficulty of operation, prognosis, quality of operation. The selected data items were statistically analyzed.ResultsThetotal number of medical records (data rows) that met the criteria was 6 116. Spearman correlation text showed a negative correlation between operative duration and years (rs=–0.433, P<0.001). In anatomy, pelvis, obesity, adhesion, mesentery, and hypertrophy, the most cases were “normal or basically normal”, and the percentages were 32.55%, 44.52%, 48.68%, 55.79%, 53.36%, and 57.72%, respectively. In quality of intestinal, the highest proportion was “bad” (43.25%). In risk of death, risk of tissue injury, and tumor recurrence, the most cases were “very small”, and the percentages were 69.00%, 94.41%, and 68.21%, respectively. In tumor metastasis, risk of anastomotic leakage, difficulty of operation, prognosis, and quality of operation, the highest proportion were “small” (48.58%), “average” (49.25%), “average” (32.96%), “uncertain” (45.65%), and “very good” (39.85%).ConclusionsIn the DACCA, the intestinal quality is characteristic of difficulty in operation, and in the evaluation of operation quality, the judgment of anastomotic leakage deserves much more attention. However, the relationship between the difficulty of operation and postoperative effects, and the relationship between the quality of operation and the prognosis still need to be further studied.
ObjectiveTo describe the difficulties and quality evaluation of colorectal cancer surgical procedures in the West China Colorectal Cancer Database (DACCA).MethodWe used the form of text description.ResultsThe related content modules of DACCA operation in West China Hospital, included operator, operative duration, anatomy (anatomical difficulty), pelvis (pelvic stenosis), obesity (abdominal obesity), adhesion (adhesion in surgical area), mesentery (abnormal mesenteric status), hypertrophy (tissue hypertrophy or organ hypertrophy), intestinal quality, death (risk of death), injury (risk of tissue injury), recurrence (tumor recurrence), metastasis (tumor metastasis), anastomotic leakage (risk of anastomotic leakage), difficulty of operation, prognosis, and quality of operation, were elaborated. Then the surgical characteristics were detailed for their definition, label, structure, error correction, and update.ConclusionThrough detailed description and specification of surgical difficulties and quality evaluation of colorectal cancer in DACCA in West China Hospital, it can provide a reference for standardized treatment of colorectal cancer and also provide experiences for the peers who wish to build a colorectal cancer database.
ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on April 16, 2020. The data items including: procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, drainage, coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants were analyzed for the characteristics of each selected data item.ResultsA total of 6 338 analyzable data rows were obtained by screening the DACCA database. Among the 6 338 pieces of data, the most common one was the double staple technique (58.1%), end-to-end anastomosis (69.4%), one-total-circle of enhancement (33.2%), and without stuffing (54.1%) in the items of procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, respectively; the ratio with drainage was higher (79.2%) in the term of drainage, the drainage time was (3.74±2.89) d and median drainage time was 3.00 d; the ratio with covering part of major omentum, without anti-adhesion material, with unilateral partial closure, without contaminate, and without drug implants were more higher, which was 41.1%, 79.8%, 58.7%, 73.9%, and 53.9% in the items of coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants, respectively.ConclusionIt might better explain the outcome of surgery associated with intraoperative operation by studying the features of surgery of DACCA and guide the operation in the future for better outcomes.
ObjectiveTo analyze the risks and complications after operation of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on July 28th, 2020. The data items included surgery reaction, body temperature, flatus, pain and mental status; preoperative complication, postoperative complication, short-term and long-term complication. The selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 6 422, including 4 185 (65.2%) valid data on surgery reaction, 3 833 (59.7%) valid data on body temperature, 3 835 (59.7%) valid data on flatus, 3 597 (56.0%) valid data on pain, 3 551 (55.3%) valid data on mental status, 6 422 (100%) valid data on preoperative complications, postoperative complications, short-term complications and long-term complications. In the surgical response, 1 517 (36.2%) lines of data showed “normal” structure were the most. Among the days with elevated body temperature, the number of 0-day data lines with the structure of “body temperature >37.5 ℃” was the highest, with 1 980 (51.7%). In postoperative flatus, there were 1 675 (43.7%) data lines with the structure showing “3 days”. The largest number of rows (2 755, 76.6%) showed a structure that was “not obvious” in the pain scale. The mental status showed the highest number of “better” rows (2 976, 83.8%). There were 50 preoperative complications (0.8%). And 595 postoperative complications (9.3%), including anastomotic leakage (80, 13.4%), inflammatory ileus (62, 10.4%), pulmonary infection (57, 9.6%), and anastomotic bleeding (56, 9.4%), etc. There were 6 169 (96.1%) without short-term complication in structural form. There were 6 283 (97.8%) without long-term complications.ConclusionsThe changes in complications shown in the real world data from DACCA suggest that the focus of postoperative risks must be changed with the over the follow-up time. As for the complication evaluation system, it is necessary to establish a complete evaluation system combining the corresponding types and risks, to carry out valuable complication researches.