Yao H W, Wang Y, An Y B, Zhang Z T
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing 100050, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Mar 25;24(3):225-229. doi: 10.3760/cma.j.cn.441530-20210120-00032.
Colorectal surgery has been developed rapidly in China because of the advance of minimally invasive surgical techniques, perioperative comprehensive treatment strategies and clinical research in recent years. Comparing the current diagnosis and treatment of colorectal cancer between China and western industrialized countries, it can be found that the specialized construction and standardized diagnosis and treatment of colorectal surgery in western industrialized countries are very mature, and the multidisciplinary diagnosis and treatment model of colorectal cancer has been standardized. Although there is almost no difference between high-level colorectal cancer centers in the eastern coastal areas of China and western countries, due to the vast size and uneven regional development of China, standardized surgery and standardized treatment concepts of colorectal surgery still need to be popularized. Combined with the current diagnosis and treatment of colorectal cancer in China, more high-quality clinical research should be carried out to seek new development and breakthroughs in the field of colorectal surgery. Combined with the experience of international and domestic clinical research that has been participated in or carried out, the author believes that quality control of clinical research should be carried out from the following two points: 1. structured training and quality control of research; 2. establishment and management of databases. In a word, we should not only focus on colon surgery itself, but also complete the transformation to research-oriented doctors and research-oriented disciplines, cultivate the concept of data collection and clinical research, enhance the scientific awareness of clinical research, and integrate high-quality data collection and clinical research into daily clinical practice. Only in this way can we fundamentally improve the comprehensive strength of China's colorectal surgery, effectively carry out surgical-related clinical research based on the current situation colorectal diseases in China, and obtain high-level evidence-based medical evidence based on the research results of the population of patients in China, and form a guide for the diagnosis and treatment of colorectal surgery in China, which will also guide the clinical practice of patients with colorectal diseases in China. This will certainly be a new direction for the development of Chinese colorectal surgery.
近年来，由于微创外科技术、围手术期综合治疗策略以及临床研究的进展，中国的结直肠外科发展迅速。对比中国与西方工业化国家目前结直肠癌的诊断与治疗情况可以发现，西方工业化国家结直肠外科的专科建设和规范化诊断治疗非常成熟，结直肠癌的多学科诊疗模式已实现标准化。虽然中国东部沿海地区的高水平结直肠癌中心与西方国家几乎没有差异，但由于中国地域辽阔、区域发展不均衡，结直肠外科的标准化手术和规范化治疗理念仍需推广。结合中国目前结直肠癌的诊断与治疗情况，应开展更多高质量的临床研究，以寻求结直肠外科领域的新发展和突破。结合参与或开展的国际国内临床研究经验，作者认为临床研究的质量控制应从以下两点进行：1. 研究的结构化培训与质量控制；2. 数据库的建立与管理。总之，我们不仅要关注结直肠手术本身，还要完成向研究型医生和研究型学科的转变，培养数据收集和临床研究的观念，增强临床研究的科学意识，并将高质量的数据收集和临床研究融入日常临床实践。只有这样，才能从根本上提高中国结直肠外科的综合实力，基于中国结直肠疾病的现状有效开展手术相关的临床研究，基于中国患者人群的研究结果获得高水平的循证医学证据，形成中国结直肠外科的诊疗指南，进而指导中国结直肠疾病患者的临床实践。这必将是中国结直肠外科发展的一个新方向。
