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人工智能在预测结直肠癌围手术期并发症中的应用与挑战

Application and challenges of artificial intelligence in predicting perioperative complications of colorectal cancer.

作者信息

Fu Yang-Yang, Jiao Yan, Liu Ya-Hui, Dong Shan-Shan

机构信息

Department of the First Operation Room, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China.

Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.

出版信息

World J Gastrointest Surg. 2025 Jul 27;17(7):106340. doi: 10.4240/wjgs.v17.i7.106340.

Abstract

Colorectal cancer (CRC) is a prevalent malignancy, with surgery playing a key role in its treatment. However, perioperative complications, such as anastomotic leaks, infections, and mortality, can significantly affect surgical outcomes, extend hospital stays, and increase healthcare costs. Traditional risk prediction models often lack precision, leading to increased interest in artificial intelligence (AI) for improving risk stratification. This review examines the application of AI, particularly machine learning and deep learning, in predicting perioperative complications in CRC surgery. AI models have been employed to predict a variety of postoperative complications, including readmissions, surgical-site infections, anastomotic leakage, and mortality, by analyzing diverse data sources such as electronic health records, medical imaging, and preoperative markers. Despite the promising results, several challenges remain, including data quality, model generalizability, the complexity of clinical data, and ethical and regulatory concerns. The review emphasizes the need for multicenter, diverse datasets and the integration of AI into clinical workflows to improve model performance and adoption. Future efforts should focus on enhancing the transparency and interpretability of AI models to ensure their successful implementation in clinical practice, ultimately improving patient outcomes and surgical decision-making in CRC surgery.

摘要

结直肠癌(CRC)是一种常见的恶性肿瘤,手术在其治疗中起着关键作用。然而,围手术期并发症,如吻合口漏、感染和死亡率,会显著影响手术结果,延长住院时间,并增加医疗成本。传统的风险预测模型往往缺乏精确性,这使得人们对利用人工智能(AI)改善风险分层的兴趣日益增加。本综述探讨了AI,特别是机器学习和深度学习,在预测CRC手术围手术期并发症方面的应用。通过分析电子健康记录、医学影像和术前标志物等多种数据源,AI模型已被用于预测各种术后并发症,包括再次入院、手术部位感染、吻合口漏和死亡率。尽管取得了令人鼓舞的结果,但仍存在一些挑战,包括数据质量、模型通用性、临床数据的复杂性以及伦理和监管问题。该综述强调需要多中心、多样化的数据集,并将AI整合到临床工作流程中,以提高模型性能和应用程度。未来的工作应侧重于提高AI模型的透明度和可解释性,以确保其在临床实践中的成功实施,最终改善CRC手术的患者预后和手术决策。

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