NDBオープンデータを用いた虫垂切除手術の実態調査

Evaluation of population-based appendectomy profiles : A retrospective cohort study

◆要旨：【目的】国内における虫垂切除手術の実態を調査した．【方法】レセプト情報・特定健診等情報データベースを用いて後方視的に検討した．【結果】2019年度，2020年度の虫垂切除手術は110,598件で，男性61,712件，女性48,886件．男性は10代，女性は40代に最も多かった．腹腔鏡下虫垂切除術94,474件（85.4％），開腹虫垂切除術16,124件（14.6％）で，膿瘍形成例においても腹腔鏡手術が多く施行されていた．高齢者では腹腔鏡手術施行率は低下していた．件数は東京都，大阪府，神奈川県の順に多く，全都道府県で腹腔鏡手術は開腹手術の件数を上回った．【結語】虫垂切除手術の現状について報告した．

［Objective］To assess the current situation of appendectomy in Japan using the National Insurance Claims Database.［Methods］In this retrospective cohort study, we evaluated 110,598 patients who underwent appendectomy between April 2019 and March 202l. The real-world data were obtained from the National Database of Health Insurance Claims and the Specific Health Checkups program of Japan.［Results］The study revealed that 61,712 males（55.8％）and 48,886（44.2％）females had undergone appendectomy within the period under review, with the highest incidence rates being among teenagers and adults（≤40years of age）. Laparoscopic appendectomy cases（94,474; 85.4％）outnumbered open appendectomy cases（16,124; 14.6％）. Although the laparoscopic appendectomy rate was very high irrespective of abscess formation, it was significantly low in elderly patients. Most surgeries were performed in Tokyo, Osaka, and Kanagawa prefectures.［Conclusion］The number of surgeries performed was dependent on the population. In all prefectures, the laparoscopic surgery rates exceeded the open surgery rates. These findings should help guide healthcare stakeholders in Japan to formulate adequate preventive measures against the identified risk factors.