Nihon Geka Gakkai zasshi
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The Japan Cardiovascular Surgery Database (JCVSD) was established in 2000 to contribute to quality improvement in cardiovascular surgery nationwide. Data are entered via the Internet, and variables were imported from the Society of Thoracic Surgeons National Database of North America. At present, the number of participating hospitals exceeds 500, and the cumulative number of data entries exceeds 220,000. ⋯ The Data Access Committee handles applications submitted for data analysis usage from participating hospitals. Based on those data analyses, more than 20 frequently cited papers have been published in international medical journals. Recently, the JCVSD has been linked with the board certification system in the field of cardiovascular medicine, in which almost all hospitals in Japan participate, and it was used for board certification in 2013 for the first time.
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Nihon Geka Gakkai zasshi · Jan 2014
[Present status and future of the National Clinical Database in the field of thoracic surgery].
The National Clinical Database (NCD) was developed to determine the present status of surgical treatment in Japan. All surgeries should be input in this database, and improvements in technique and specialists are expected after analyzing the cumulative data. ⋯ However, the indications and surgical procedures appear to differ by institution. Analysis of numerous prospective data on lung cancer surgeries in the NCD should provide invaluable information for setting standard procedures and policies.
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Nihon Geka Gakkai zasshi · Jan 2014
[A paradigm shift in pediatric surgery created by the National Clinical Database].
The use of data from the National Clinical Database (NCD) is becoming more important in pediatric surgery. First, it is possible to review all surgical data in the NCD. Although pediatric surgeons treat a wide variety of conditions, with the exceptions of common ones such as appendicitis or inguinal hernia, rare anomalies with an incidence of only one in 1,000 births account for most cases. ⋯ However, until the creation of the NCD it was not clear which types of medical care were given at which institutions. Analysis of the reasonable placement of specialists or the ideal system of pediatric surgical emergency care can now be conducted based on scientific grounds by analyzing data from the NCD provided by all surgeons. For those performing pediatric surgery, the true value of the NCD will be determined in the future based on how they cope with this paradigm shift.
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Nihon Geka Gakkai zasshi · May 2013
[Guidelines on live demonstrations of thoracic and cardiovascular surgery: pros and cons].
Guidelines on live demonstrations of cardiothoracic surgery were established in Japan following a single incident of an inappropriately performed live demonstration of an open repair of a thoracic aneurysm. Although the guidelines have contributed to ensuring patient safety and privacy, live demonstrations of surgical procedures in Japan have nearly been eliminated due to their strict regulations. However, since the guidelines only apply to surgeons who belong to surgical societies, live demonstrations performed by interventionalists are still performed without following the guidelines. ⋯ At Jikei University, we have held seven live demonstration symposiums with 5,700 participants, of whom 90% provided positive feedback on the value of the live demonstrations. In addition, a survey showed that the morbidity and mortality rates of the 122 live demonstrations performed during this period did not differ from those of similar procedures performed conventionally at our institution, indicating that live demonstration surgery can be performed without compromising safety. If performed by experienced surgeons obeying the guideline, live demonstration surgery is an effective, safe educational tool.