Ito Sunao, Takahashi Arata, Ueno Hideki, Takiguchi Shuji, Kajiwara Yoshiki, Kakeji Yoshihiro, Eguchi Susumu, Goi Takanori, Saiura Akio, Sasaki Akira, Takeuchi Hiroya, Tanaka Chie, Hashimoto Masaji, Hiki Naoki, Horiguchi Akihiko, Matsuda Satoru, Mizushima Tsunekazu, Yamamoto Hiroyuki, Kitagawa Yuko, Shirabe Ken
The Japanese Society of Gastroenterological Surgery Tokyo Japan.
Department of Gastroenterological Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Aichi Japan.
Ann Gastroenterol Surg. 2024 Oct 17;9(1):32-59. doi: 10.1002/ags3.12868. eCollection 2025 Jan.
The Japanese National Clinical Database, which covers more than 95% of the surgeries performed in Japan, is the largest nationwide database. This is the 2021 annual report of the Gastroenterological Section of the National Clinical Database, which aims to present the short-term outcomes of cases registered in 2021 and discuss significant changes and insights into gastroenterological surgeries observed over the decade.
We reviewed the data of patients registered in the National Clinical Database between 2012 and 2021.
In total, 5 788 093 cases, including 597 780 cases in 2021, were extracted from the National Clinical Database. The number of surgeries resumed its original trend after a uniform decrease due to the coronavirus disease 2019 pandemic. The patient population continues to age, and the proportion of female patients is steadily increasing. The trend of surgeries being conducted in certified institutions with the involvement of board-certified surgeons is consistently rising. Moreover, the increasing trend of endoscopic surgery rate is still maintained. Although operative mortality is declining, the trend of increasing postoperative complications continues. Surgery on the esophagus, liver, and pancreas has shown substantial improvements in operative mortality, with a high participation rate of board-certified surgeons. Surgical procedures with a high incidence of emergency surgeries are characterized by low participation rates of board-certified surgeons, increased morbidity rates, and worse mortality outcomes.
This overview of surgical patients in Japan, obtained using data extracted from the National Clinical Database, may serve as a critical cornerstone for the future development of gastroenterological surgery.
日本国家临床数据库覆盖了日本95%以上的手术病例，是全国最大的数据库。这是国家临床数据库胃肠病学部分的2021年度报告，旨在呈现2021年登记病例的短期结果，并讨论十年来胃肠外科手术中观察到的重大变化和见解。
我们回顾了2012年至2021年在国家临床数据库中登记的患者数据。
从国家临床数据库中总共提取了5788093例病例，其中2021年有597780例。由于2019冠状病毒病大流行，手术数量在统一下降后恢复了原来的趋势。患者群体持续老龄化，女性患者比例稳步上升。在获得认证的机构中，由获得董事会认证的外科医生参与进行手术的趋势持续上升。此外，内镜手术率的上升趋势仍在保持。尽管手术死亡率在下降，但术后并发症增加的趋势仍在持续。食管、肝脏和胰腺手术的手术死亡率有了显著改善，获得董事会认证的外科医生参与率很高。急诊手术发生率高的手术特点是获得董事会认证的外科医生参与率低、发病率增加以及死亡率结果更差。
使用从国家临床数据库中提取的数据对日本手术患者进行的这一概述，可能成为胃肠外科未来发展的关键基石。
