Wu Zhouqiao, Gu Tingfei, Wang Xin, Wei Tianxiao, Shan Fei, Li Ziyu, Ji Jiafa
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing, China.
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Beijing, China.
BMJ Surg Interv Health Technol. 2025 Jul 15;7(1):e000332. doi: 10.1136/bmjsit-2024-000332. eCollection 2025.
This study aimed to assess the surgical quality, safety, and healthcare utilization associated with gastric cancer surgery in China, using international studies for benchmarking.
A prospective registered study was conducted utilizing data from the Prevalence of Abdominal Complications After Gastroenterological Surgery study, comprised of 1859 patients without postoperative complications (non-POC group) and 412 patients with at least one POC group. Baseline characteristics, surgical outcomes, and healthcare utilization were compared between groups, and results were further contextualized through a review of international multicenter studies.
20 centers across China, with data collected from December 2018 to December 2020.
2271 patients who underwent gastrectomy for gastric cancer, including 1859 in the non-POC group and 412 in the POC group.
POC incidence, postoperative hospital stay, healthcare costs, and cross-regional comparisons of surgical quality.
Patients with POCs exhibited distinct baseline and intraoperative profiles compared with those without. The most frequent complications were respiratory infections, anastomotic leakage, and non-leak intra-abdominal infections. Among surgical types, proximal gastrectomy had the highest POC incidence. Costs and postoperative hospital stay were significantly higher in patients with these complications. Compared with international cohorts, China demonstrated comparable surgical quality and complication profiles. However, the cost burden associated with major POCs was substantially lower in China, despite similar hospital stays.
China's gastric cancer surgery outcomes align with international standards in terms of surgical quality and complication rates. Notably, major complications were associated with significantly lower costs than those reported internationally, suggesting greater cost advantages in postoperative management. These findings highlight the value of robust complication reporting systems and evidence-based management protocols in delivering cost-effective, high-quality surgical care.
NCT03828266.
本研究旨在通过与国际研究进行对比，评估中国胃癌手术的质量、安全性及医疗资源利用情况。
采用前瞻性注册研究，利用胃肠外科手术后腹部并发症患病率研究的数据，该研究包括1859例无术后并发症患者（非术后并发症组）和412例至少有一项术后并发症的患者（术后并发症组）。比较两组的基线特征、手术结果和医疗资源利用情况，并通过回顾国际多中心研究进一步分析结果。
中国20个中心，数据收集时间为2018年12月至2020年12月。
2271例行胃癌胃切除术的患者，其中非术后并发症组1859例，术后并发症组412例。
术后并发症发生率、术后住院时间、医疗费用以及手术质量的跨地区比较。
与无术后并发症的患者相比，有术后并发症的患者表现出不同的基线和术中特征。最常见的并发症是呼吸道感染、吻合口漏和非漏性腹腔内感染。在手术类型中，近端胃切除术的术后并发症发生率最高。这些并发症患者的费用和术后住院时间显著更高。与国际队列相比，中国的手术质量和并发症情况相当。然而，尽管住院时间相似，但中国主要术后并发症的成本负担明显低于国际报道。
中国胃癌手术在手术质量和并发症发生率方面与国际标准相符。值得注意的是，主要并发症的成本明显低于国际报道，表明术后管理具有更大的成本优势。这些发现凸显了强大的并发症报告系统和循证管理方案在提供具有成本效益的高质量手术护理方面的价值。
NCT03828266。
