• Open Access

Nationwide survey and establishment of a clinical database for gastrointestinal surgery in Japan: Targeting integration of a cancer registration system and improving the outcome of cancer treatment

Authors

  • Hiroyuki Suzuki,

    1. Department of Organ-regenerative Surgery, Fukushima Medical University, Fukushima
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Mitsukazu Gotoh,

    Corresponding author
    1. Department of Organ-regenerative Surgery, Fukushima Medical University, Fukushima
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    • Chairman of the CDCJSGS.

  • Kenichi Sugihara,

    1. Department of Surgical Oncology, Graduate School, Tokyo Medical and Dental University, Tokyo
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    • Chairman of the Japanese Society of Gastrointestinal Surgery.

  • Yuko Kitagawa,

    1. Department of Surgery, Keio University, Tokyo
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Wataru Kimura,

    1. First Department of Surgery, Yamagata University, Yamagata
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Satoshi Kondo,

    1. Second Department of Surgery, Hokkaido University, Sapporo
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Mitsuo Shimada,

    1. Department of Digestive and Pediatric Surgery, The University of Tokushima, Tokushima
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Naohiro Tomita,

    1. Second Department of Surgery, Hyogo College of Medicine, Nishinomiya
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Tohru Nakagoe,

    1. Department of Surgery, Saiseikai Nagasaki Hospital, Nagasaki
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Hideki Hashimoto,

    1. Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Hideo Baba,

    1. Department of Gastroenterological Surgery, Kumamoto University, Kumamoto
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Hiroaki Miyata,

    1. Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).

  • Noboru Motomura

    1. Department of Cardiothoracic Surgery, The University of Tokyo, Tokyo, Japan
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    • Member of the Working Group of the Clinical Database Committee of the Japanese Society of Gastrointestinal Surgery (CDCJSGS).


To whom correspondence should be addressed.
E-mail: mgotoh@fmu.ac.jp

Abstract

As there was no nationwide database for gastrointestinal surgery in Japan at the time, in 2006, a Clinical Database Committee was established in the Japanese Society of Gastrointestinal Surgery (JSGS) to create a clinical database in Japan. The Committee first organized preliminary nationwide Japanese surveys in gastrointestinal surgery in 2006 and 2007. Data from more than 770 000 patients were accumulated from these web-based surveys, including 333 627 patients in 1039 institutions in 2006 and 440 230 patients in 1464 institutions in 2007. The mortality rate was stratified by organ, surgical procedure and hospital volume without using risk-adjustment techniques. The overall mortality rate was 0.95% in the 2006 survey and 0.92% in the 2007 survey. The organ-based analysis found that the mortality rates were almost similar in 2006 and 2007. Hospital volume influenced the mortality rate in six major surgical procedures, namely esophagectomy, gastrectomy, total gastrectomy, low anterior rectal resection, hepatic resection and pancreaticoduodenectomy. A risk reduction of 30–80% was noted in each surgical procedure, at least in our non-risk-adjusted analysis, in hospitals with a high volume of operations. These preliminary surveys indicate that hospital volume might influence the mortality rate after major abdominal surgery. Further analysis using risk-adjustment techniques should be conducted to understand the specific contribution of hospital volume to surgical mortality. A nationwide database of patients who have undergone gastrointestinal surgery and risk-adjustment analysis of the data are currently planned in Japan. (Cancer Sci 2011; 102: 226–230)

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