Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan
Abstract Aim The use of minimally invasive surgery, including laparoscopic and robotic surgery, for gastrointestinal cancer has been rapidly increasing. This study aimed to clarify whether differences in minimally invasive surgery outcomes are associated with regional and patient characteristics. Me...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-07-01
|
| Series: | Annals of Gastroenterological Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ags3.70007 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839645619565625344 |
|---|---|
| author | Atsushi Hamabe Arata Takahashi Hiraku Kumamaru Hiroshi Hasegawa Koki Otsuka Yoshihiro Kakeji Ken Shirabe Masafumi Inomata Yuko Kitagawa Ichiro Takemasa |
| author_facet | Atsushi Hamabe Arata Takahashi Hiraku Kumamaru Hiroshi Hasegawa Koki Otsuka Yoshihiro Kakeji Ken Shirabe Masafumi Inomata Yuko Kitagawa Ichiro Takemasa |
| author_sort | Atsushi Hamabe |
| collection | DOAJ |
| description | Abstract Aim The use of minimally invasive surgery, including laparoscopic and robotic surgery, for gastrointestinal cancer has been rapidly increasing. This study aimed to clarify whether differences in minimally invasive surgery outcomes are associated with regional and patient characteristics. Methods A total of 123 771 right hemicolectomy and 126 965 low anterior resection cases performed between 2013 and 2019 were selected from the National Clinical Database for analysis. Patients were stratified by regional and economic variables, and open and minimally invasive surgical outcomes were evaluated. Results In secondary medical regions characterized by urban settings and numerous designated cancer care hospitals, the observed 30‐day mortality of low anterior resections was lower only in the minimally invasive surgery group. For right hemicolectomies in regions with many designated cancer care hospitals, the observed incidence of postoperative complications was also lower in the minimally invasive group. Residents of high‐income areas undergoing low anterior resection had a lower frequency of 30‐day reoperation regardless of the type of surgery and a lower 30‐day mortality in the minimally invasive group. For both right hemicolectomy and low anterior resection, patients with longer travel distances had fewer postoperative complications and lower 30‐day reoperation rates in the minimally invasive group than in the open surgery group. Conclusion This study found regional and patient characteristic disparities in minimally invasive surgical outcomes; national policies should be implemented to address these inequities. |
| format | Article |
| id | doaj-art-e7a8367af0894a08b54c1c8fd6a7c5f2 |
| institution | Matheson Library |
| issn | 2475-0328 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj-art-e7a8367af0894a08b54c1c8fd6a7c5f22025-07-01T14:20:07ZengWileyAnnals of Gastroenterological Surgery2475-03282025-07-019476978410.1002/ags3.70007Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in JapanAtsushi Hamabe0Arata Takahashi1Hiraku Kumamaru2Hiroshi Hasegawa3Koki Otsuka4Yoshihiro Kakeji5Ken Shirabe6Masafumi Inomata7Yuko Kitagawa8Ichiro Takemasa9Department of Surgery, Surgical Oncology and Science Sapporo Medical University Sapporo JapanDepartment of Health Policy and Management, School of Medicine Keio University Tokyo JapanDepartment of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo Tokyo JapanDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine Kobe University Kobe JapanProject Management Subcommittee, The Japanese Society of Gastroenterological Surgery Tokyo JapanDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine Kobe University Kobe JapanDepartment of General Surgical Science Gunma University Graduate School of Medicine Maebashi Gunma JapanDepartment of Gastroenterological and Pediatric Surgery, Faculty of Medicine Oita University Oita JapanDepartment of Surgery Keio University School of Medicine Tokyo JapanDepartment of Gastroenterological Surgery Osaka International Medical and Science Center, Osaka Keisatsu Hospital Osaka JapanAbstract Aim The use of minimally invasive surgery, including laparoscopic and robotic surgery, for gastrointestinal cancer has been rapidly increasing. This study aimed to clarify whether differences in minimally invasive surgery outcomes are associated with regional and patient characteristics. Methods A total of 123 771 right hemicolectomy and 126 965 low anterior resection cases performed between 2013 and 2019 were selected from the National Clinical Database for analysis. Patients were stratified by regional and economic variables, and open and minimally invasive surgical outcomes were evaluated. Results In secondary medical regions characterized by urban settings and numerous designated cancer care hospitals, the observed 30‐day mortality of low anterior resections was lower only in the minimally invasive surgery group. For right hemicolectomies in regions with many designated cancer care hospitals, the observed incidence of postoperative complications was also lower in the minimally invasive group. Residents of high‐income areas undergoing low anterior resection had a lower frequency of 30‐day reoperation regardless of the type of surgery and a lower 30‐day mortality in the minimally invasive group. For both right hemicolectomy and low anterior resection, patients with longer travel distances had fewer postoperative complications and lower 30‐day reoperation rates in the minimally invasive group than in the open surgery group. Conclusion This study found regional and patient characteristic disparities in minimally invasive surgical outcomes; national policies should be implemented to address these inequities.https://doi.org/10.1002/ags3.70007colorectal neoplasmsminimally invasive surgical proceduresNational Clinical Database |
| spellingShingle | Atsushi Hamabe Arata Takahashi Hiraku Kumamaru Hiroshi Hasegawa Koki Otsuka Yoshihiro Kakeji Ken Shirabe Masafumi Inomata Yuko Kitagawa Ichiro Takemasa Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan Annals of Gastroenterological Surgery colorectal neoplasms minimally invasive surgical procedures National Clinical Database |
| title | Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan |
| title_full | Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan |
| title_fullStr | Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan |
| title_full_unstemmed | Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan |
| title_short | Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan |
| title_sort | regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in japan |
| topic | colorectal neoplasms minimally invasive surgical procedures National Clinical Database |
| url | https://doi.org/10.1002/ags3.70007 |
| work_keys_str_mv | AT atsushihamabe regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT aratatakahashi regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT hirakukumamaru regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT hiroshihasegawa regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT kokiotsuka regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT yoshihirokakeji regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT kenshirabe regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT masafumiinomata regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT yukokitagawa regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan AT ichirotakemasa regionalandpatientcharacteristicdisparitiesintheoutcomesofminimallyinvasivesurgeryforcolorectalcancerinjapan |