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Surgery Today
Published in: Surgery Today 2/2021

01-02-2021 | Esophagus Resection | Review Article

Development of gastroenterological surgery over the last decade in Japan: analysis of the National Clinical Database

Authors: Yoshihiro Kakeji, Hiroyuki Yamamoto, Hideki Ueno, Susumu Eguchi, Itaru Endo, Akira Sasaki, Shuji Takiguchi, Hiroya Takeuchi, Masaji Hashimoto, Akihiko Horiguchi, Tadahiko Masaki, Shigeru Marubashi, Kazuhiro Yoshida, Hiroaki Miyata, Hiroyuki Konno, Mitsukazu Gotoh, Yuko Kitagawa, Masaki Mori, Yasuyuki Seto

Published in: Surgery Today | Issue 2/2021

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Abstract

The National Clinical Database (NCD) of Japan was established in 2010 with the board certification system. A joint committee of 16 gastroenterological surgery database-affiliated organizations has been nurturing this nationwide database and utilizing its data for various analyses. Stepwise board certification systems have been validated by the NCD and are used to improve the surgical outcomes of patients. The use of risk calculators based on risk models can be particularly helpful for establishing appropriate and less invasive surgical treatments for individual patients. Data obtained from the NCD reflect current developments in the surgical approaches used in hospitals, which have progressed from open surgery to endoscopic and robot-assisted procedures. An investigation of the data acquired by the NCD could answer some relevant clinical questions and lead to better surgical management of patients. Furthermore, excellent surgical outcomes can be achieved through international comparisons of the national databases worldwide. This review examines what we have learned from the NCD of gastroenterological surgery and discusses what future developments we can expect.
Literature
1.
Gotoh M, Miyata H, Hashimoto H, Wakabayashi G, Konno H, Miyakawa S, et al. National clinical database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency. Surg Today. 2016;46:38–47.PubMed
2.
Miyata H, Gotoh M, Hashimoto H, Motomura N, Murakami A, Tomotaki A, et al. Challenges and prospects of a clinical database linked to the board certification system. Surg Today. 2014;44:1991–9.PubMed
3.
Seto Y, Kakeji Y, Miyata H, Iwanaka T. National Clinical Database (NCD) in Japan for gastroenterological surgery: Brief introduction. Ann Gastroenterol Surg. 2017;1:80–1.PubMedPubMedCentral
4.
Seto Y. National Clinical Database (NCD) shows the trend for centralization of major surgery: should it depend on hospital or surgeon volume? Ann Gastroenterol Surg. 2019;3:340–2.PubMedPubMedCentral
5.
Tomotaki A, Kumamaru H, Hashimoto H, Takahashi A, Ono M, Iwanaka T, et al. Evaluating the quality of data from the Japanese National Clinical Database 2011 via a comparison with regional government report data and medical charts. Surg Today. 2019;49:65–71.PubMed
6.
Kanaji S, Takahashi A, Miyata H, Marubashi S, Kakeji Y, Konno H, et al. Initial verification of data from a clinical database of gastroenterological surgery in Japan. Surg Today. 2019;49:328–33.PubMed
7.
Konno H, Kamiya K, Kikuchi H, Miyata H, Hirahara N, Gotoh M, et al. Association between the participation of board-certified surgeons in gastroenterological surgery and operative mortality after eight gastroenterological procedures. Surg Today. 2017;47:611–8.PubMed
8.
Makino I, Miyata H, Ohta T, Gotoh M, Konno H, Mori M, et al. Investigation of current actual condition of medical system in Japan on the basis of secondary medical area for establishing a new training program for medical specialist (in Japanese). Jpn J Gastroenterol Surg. 2016;49(11):1181–90.
9.
Nishigori T, Miyata H, Okabe H, Toh Y, Matsubara H, Konno H, et al. Impact of hospital volume on risk-adjusted mortality following oesophagectomy in Japan. Br J Surg. 2016;103:1880–6.PubMed
10.
Iwatsuki M, Yamamoto H, Miyata H, Kakeji Y, Yoshida K, Konno H, et al. Effect of hospital and surgeon volume on postoperative outcomes after distal gastrectomy for gastric cancer based on data from 145,523 Japanese patients collected from a nationwide web-based data entry system. Gastric Cancer. 2019;22:190–201.PubMed
11.
Ohki T, Yamamoto M, Miyata H, Sato Y, Saida Y, Morimoto T, et al. A comparison of the surgical mortality due to colorectal perforation at different hospitals with data from 10,090 cases in the Japanese National Clinical Database. Medicine. 2017;96(2):e5818.PubMedPubMedCentral
12.
Motoyama S, Yamamoto H, Miyata H, Yano M, Yasuda T, Ohira M, et al. Impact of certification status of the institute and surgeon on short-term outcomes after surgery for thoracic esophageal cancer: evaluation using data on 16,752 patients from the National Clinical Database in Japan. Esophagus. 2020;17:41–9.PubMed
13.
Miura F, Yamamoto M, Gotoh M, Konno H, Fujimoto J, Yanaga K, et al. Validation of the board certification system for expert surgeons (hepato-biliary-pancreatic field) using the data of the National Clinical Database of Japan: part 1-hepatectomy of more than one segment. J Hepatobiliary Pancreat Sci. 2016;23:313–23.PubMed
14.
Miura F, Yamamoto M, Gotoh M, Konno H, Fujimoto J, Yanaga K, et al. Validation of the board certification system for expert surgeons (hepato-biliary-pancreatic field) using the data of the National Clinical Database of Japan: part 2-pancreatoduodenectomy. J Hepatobiliary Pancreat Sci. 2016;23:353–63.PubMed
15.
Nakata K, Yamamoto H, Miyata H, Kakeji Y, Seto Y, Yamaue H, et al. Definition of the objective threshold of pancreatoduodenectomy with nationwide data systems. J Hepatobiliary Pancreat Sci. 2020;27:107–13.PubMed
16.
Toh Y, Yamamoto H, Miyata H, Gotoh M, Watanabe M, Matsubara H, et al. Significance of the board-certified surgeon systems and clinical practice guideline adherence to surgical treatment of esophageal cancer in Japan: a questionnaire survey of departments registered in the National Clinical Database. Esophagus. 2019;16:362–70.PubMedPubMedCentral
17.
Kobayashi H, Yamamoto H, Miyata H, Gotoh M, Kotake K, Sugihara K, et al. Impact of the board-certified surgeon systems and clinical practice guideline adherence to surgical treatment of colon cancer in Japan—a questionnaire survey of the National Clinical Database. Ann Gastroenterol Surg. 2020;4:283–93.PubMedPubMedCentral
18.
19.
Mizushima T, Yamamoto H, Marubashi S, Kamiya K, Wakabayashi G, Miyata H, et al. Validity and significance of 30-day mortality rate as a quality indicator for gastrointestinal cancer surgeries. Ann Gastroenterol Surg. 2018;2:231–40.PubMedPubMedCentral
20.
Takeuchi H, Miyata H, Gotoh M, Kitagawa Y, Baba H, Kimura W, et al. A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database. Ann Surg. 2014;260(2):259–66.PubMed
21.
Kurita N, Miyata H, Gotoh M, Shimada M, Imura S, Kimura W, et al. Risk model for distal gastrectomy when treating gastric cancer based on data from 33, 917 Japanese patients collected using a nationwide we-based data entry system. Ann Surg. 2015;262(2):295–303.PubMed
22.
Watanabe M, Miyata H, Gotoh M, Baba H, Kimura W, Tomita N, et al. Total gastrectomy risk model: data from 20,011 Japanese patients in a nationwide internet-based database. Ann Surg. 2014;260(6):1034–9.PubMed
23.
Kobayashi H, Miyata H, Gotoh M, Baba H, Kimura W, Kitagawa Y, et al. Risk model for right hemicolectomy based on 19,070 Japanese patients in the National Clinical Database. J Gastroenterol. 2014;49(6):1047–55.PubMed
24.
Matsubara N, Miyata H, Gotoh M, Tomita N, Baba H, Kimura W, et al. Mortality after common rectal surgery in Japan: a study on low anterior resection from a newly established nationwide large-scale clinical database. Dis Colon Rectum. 2014;57(9):1075–81.PubMed
25.
Kenjo A, Miyata H, Gotoh M, Kitagawa Y, Shimada M, Baba H, et al. Risk stratification of 7,732 hepatectomy cases in 2011 from the National Clinical Database for Japan. J Am Coll Surg. 2014;218(3):412–22.PubMed
26.
Kimura W, Miyata H, Gotoh M, Hirai I, Kenjo A, Kitagawa Y, et al. A pancreaticoduodenectomy risk model derived from 8575 cases from a national single-race population (Japanese) using a web-based data entry system: the 30-day and in-hospital mortality rates for pancreaticoduodenectomy. Ann Surg. 2014;259(4):773–80.PubMed
27.
Nakagoe T, Miyata H, Gotoh M, Anazawa T, Baba H, Kimura W, et al. Surgical risk model for acute diffuse peritonitis based on a Japanese nationwide database: an initial report on the surgical and 30-day mortality. Surg Today. 2015;45(10):1233–43.PubMed
28.
29.
Kunisaki C, Miyata H, Konno H, Saze Z, Hirahara N, Kikuchi H, et al. Modeling preoperative risk factors for potentially lethal morbidities using a nationwide Japanese web-based database of patients undergoing distal gastrectomy for gastric cancer. Gastric Cancer. 2017;20:496–507.PubMed
30.
Kikuchi H, Miyata H, Konno H, Kamiya K, Tomotaki A, Gotoh M, et al. Development and external validation of preoperative risk models for operative morbidities after total gastrectomy using a Japanese web-based nationwide registry. Gastric Cancer. 2017;20:987–97.PubMedPubMedCentral
31.
Yoshida T, Miyata H, Konnno H, Kumamaru H, Tangoku A, Furukita Y, et al. Risk assessment of morbidities after right hemicolectomy based on the National Clinical Database in Japan. Ann Gastroenterol Surg. 2018;2:220–30.PubMedPubMedCentral
32.
Watanabe T, Miyata H, Konno H, Kawai K, Ishihara S, Sunami E, et al. Prediction model for complications after low anterior resection based on data from 33,411 Japanese patients included in the National Clinical Database. Surgery. 2017;161:1597–608.PubMed
33.
Yokoo H, Miyata H, Konno H, Taketomi A, Kakisaka T, Hirahara N, et al. Models predicting the risks of six life-threatening morbidities and bile leakage in 14,970 hepatectomy patients registered in the National Clinical Database of Japan. Medicine (Baltimore). 2016;95:e5466.
34.
Aoki S, Miyata H, Gotoh M, Motoi F, Kumamaru H, Konno H, et al. Risk factors of serious postoperative complications after pancreaticoduodenectomy and risk calculators for predicting postoperative complications: a nationwide study of 17,564 patients in Japan. J Hepatobiliary Pancreat Sci. 2017;24:243–51.PubMedPubMedCentral
35.
Saze Z, Miyata H, Konno H, Gotoh M, Anazawa T, Tomotaki A, et al. Risk models of operative morbidities in 16,930 critically ill surgical patients based on a Japanese nationwide database. Medicine (Baltimore). 2015;94:e1224.PubMedPubMedCentral
36.
Marubashi S, Ichihara N, Kakeji Y, Miyata H, Taketomi A, Egawa H, et al. “Real-time” risk models of postoperative morbidity and mortality for liver transplants. Ann Gastroenterol Surg. 2019;3:75–95.PubMed
37.
Haga Y, Miyata H, Tsuburaya A, Gotoh M, Yoshida K, Konno H, et al. Development and validation of grade-based prediction models for postoperative morbidity in gastric cancer resection using a Japanese web-based nationwide registry. Ann Gastroenterol Surg. 2019;3:544–51.PubMedPubMedCentral
38.
Takesue Y, Miyata H, Gotoh M, Wakabayashi G, Konno H, Mori M, et al. Risk calculator for predicting postoperative pneumonia after gastroenterological surgery based on a national Japanese database. Ann Gastroenterol Surg. 2019;3:405–15.PubMedPubMedCentral
39.
Hashimoto D, Mizuma M, Kumamaru H, Miyata H, Chikamoto A, Igarashi H, et al. Risk model for severe postoperative complications after total pancreatectomy based on a nationwide clinical database. Br J Surg. 2020;107:734–42.PubMed
40.
Kubota K, Aoki T, Kumamaru H, Shiraki T, Miyata H, Seto Y, et al. Use of the National Clinical Database to evaluate the association between preoperative liver function and postoperative complications among patients undergoing hepatectomy. J Hepatobiliary Pancreat Sci. 2019;26:331–40.PubMed
41.
Kakeji Y, Takahashi A, Udagawa H, Unno M, Endo I, Kunisaki C, et al. Surgical outcomes in gastroenterological surgery in Japan: report of National Clinical database 2011–2016. Ann Gastroenterol Surg. 2018;2:37–54.PubMed
42.
Hasegawa H, Takahashi A, Kakeji Y, Ueno H, Eguchi S, Endo I, et al. Surgical outcomes of gastroenterological surgery in Japan: report of the National Clinical Database 2011–2017. Ann Gastroenterol Surg. 2019;00:1–25.
43.
Kakeji Y, Takahashi A, Hasegawa H, Ueno H, Eguchi S, Endo I, et al. Surgical outcomes in gastroenterological surgery in Japan. Report of National Clinical database 2011–2018. Ann Gastroenterol Surg. 2020;4:250–74.PubMedPubMedCentral
44.
Yoshida K, Honda M, Kumamaru H, Kodera Y, Kakeji Y, Hiki N, et al. Surgical outcomes of laparoscopic distal gastrectomy compared to open distal gastrectomy: a retrospective cohort study based on a nationwide registry database in Japan. Ann Gastroenterol Surg. 2017;2:55–64.PubMedPubMedCentral
45.
Hiki N, Honda M, Etoh T, Yoshida K, Kodera Y, Kakeji Y, et al. Higher incidence of pancreatic fistula in laparoscopic gastrectomy. Real-world evidence from a nationwide prospective cohort study. Gastric Cancer. 2018;21:162–70.PubMed
46.
Kodera Y, Yoshida K, Kumamaru H, Kakeji Y, Hiki N, Etoh T, et al. Introducing laparoscopic total gastrectomy for gastric cancer in general practice: a retrospective cohort study based on a nationwide registry database in Japan. Gastric Cancer. 2019;22:202–13.PubMed
47.
Etoh T, Honda M, Kumamaru H, Miyata H, Yoshida K, Kodera Y, et al. Morbidity and mortality from a propensity score-matched, prospective cohort study of laparoscopic versus open total gastrectomy for gastric cancer: data from a nationwide web-based database. Surg Endosc. 2018;32:2766–73.PubMed
48.
Miyata H, Mori M, Kokudo N, Gotoh M, Konno H, Wakabayashi G, et al. Association between institutional procedural preference and in-hospital outcomes in laparoscopic surgeries; insights from a retrospective cohort analysis of a nationwide surgical database in Japan. PLoS ONE. 2018;13(3):e0193186.PubMedPubMedCentral
49.
Honda M, Kumamaru H, Etoh T, Miyata H, Yamashita Y, Yoshida K, et al. Surgical risk and benefits of laparoscopic surgery for elderly patients with gastric cancer: a multicenter prospective cohort study. Gastric Cancer. 2019;22:845–52.PubMed
50.
Inokuchi M, Kumamaru H, Nakagawa M, Miyata H, Kakeji Y, Seto Y, et al. Feasibility of laparoscopic gastrectomy for patients with poor physical status: a retrospective cohort study based on a nationwide registry database in Japan. Gastric Cancer. 2020;23:310–8.PubMed
51.
Takeuchi H, Miyata H, Ozawa S, Udagawa H, Osugi H, Matsubara H, et al. Comparison of short-term outcomes between open and minimally invasive esophagectomy for esophageal cancer using a nationwide database in Japan. Ann Surg Oncol. 2017;24:1821–7.PubMed
52.
Yoshida N, Yamamoto H, Baba H, Miyata H, Watanabe M, Toh Y, et al. Can minimally invasive esophagectomy replace open esophagectomy for esophageal cancer? Latest analysis of 24,233 esophagectomies from the Japanese National Clinical Database. Ann Surg. 2020;272:118–24.PubMed
53.
Takahara T, Wakabayashi G, Konno H, Gotoh M, Yamaue H, Yanaga K, et al. Comparison of laparoscopic major hepatectomy with propensity score matched open cases from the National Clinical Database in Japan. J Hepatobiliary Pancreat Sci. 2016;23:721–34.PubMed
54.
55.
Ri M, Miyata H, Aikou S, Seto Y, Akazawa K, Takeuchi M, et al. Effects of body mass index (BMI) on surgical outcomes: a nationwide survey using a Japanese web-based database. Surg Today. 2015;45:1271–9.PubMed
56.
Hata T, Ikeda M, Miyata H, Nomura M, Gotoh M, Sakon M, et al. Frequency and risk factors for venous thromboembolism after gastroenterological surgery based on the Japanese National Clinical Database (516,217 cases). Ann Gastroenterol Surg. 2019;3:534–43.PubMedPubMedCentral
57.
Anazawa T, Paruch JL, Miyata H, Gotoh M, Ko CY, Cohen ME, et al. Comparison of national operative mortality in gastroenterological surgery using web-based prospective data entry systems. Medicine (Baltimore). 2015;94:e2194.PubMedPubMedCentral
58.
Marubashi S, Liu JY, Miyata H, Cohen ME, Ko CY, Seto Y, et al. Surgical quality improvement programs in Japan and USA: report from the collaborative projects between Japanese Society of Gastroenterological Surgery and American College of Surgeons National Surgical Quality Improvement Program. Ann Gastroenterol Surg. 2019;3:343–51.PubMedPubMedCentral
59.
Mizuma M, Unno M, Igarashi H, Itoi T, Egawa S, Kodama Y, et al. Japan Pancreatic Cancer Registry of Japan Pancreas Society: comparison between the conventional database and National Clinical Database (NCD). Pancreatology. 2016;16(s4):s90.
Metadata
Title
Development of gastroenterological surgery over the last decade in Japan: analysis of the National Clinical Database
Authors
Yoshihiro Kakeji
Hiroyuki Yamamoto
Hideki Ueno
Susumu Eguchi
Itaru Endo
Akira Sasaki
Shuji Takiguchi
Hiroya Takeuchi
Masaji Hashimoto
Akihiko Horiguchi
Tadahiko Masaki
Shigeru Marubashi
Kazuhiro Yoshida
Hiroaki Miyata
Hiroyuki Konno
Mitsukazu Gotoh
Yuko Kitagawa
Masaki Mori
Yasuyuki Seto
Publication date
01-02-2021
Publisher
Springer Singapore
Published in
Surgery Today / Issue 2/2021
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02075-7

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