To provide a nationwide overview of groin hernia surgeries in Japan, using data from the National Clinical Database (NCD) as of 2023, with emphasis on procedure types, demographic trends, and hernia classification by sex and recurrence status. We analyzed data on groin hernia surgeries registered in the NCD from January to December, 2023. Procedures were classified into four categories: open or endoscopic, and inguinal or femoral. Variables included age, sex, surgical urgency, anesthesiologist involvement, and admission type. Longitudinal trends (2011–2023) and sex-/recurrence-specific differences were also evaluated. A total of 127,139 groin hernia repairs were performed at 2,143 institutions. Inguinal hernias accounted for 96.5
To evaluate contemporary short-term outcomes of robotic gastrectomy (RG) approximately 5 years after its widespread implementation, compared with laparoscopic gastrectomy (LG) using a nationwide Japanese database. RG has been introduced to overcome the technical limitations of LG; however, its real-world clinical advantages remain to be fully defined. This retrospective study used the Japanese National Clinical Database to identify patients with gastric cancer who underwent minimally invasive distal gastrectomy (DG) or total gastrectomy (TG) between January 2023 and December 2024. Patients were classified as undergoing robotic (RDG or RTG) or laparoscopic (LDG or LTG) procedures. Propensity score matching was performed separately for the DG and TG cohorts to adjust for patient-, tumor-, and hospital-related confounders. The primary outcome was postoperative morbidity within 30 days (Clavien–Dindo grade ≥ IIIa). After propensity score matching, 9743 RDG–LDG pairs and 1617 RTG–LTG pairs were analyzed. RDG was associated with a significantly lower morbidity rate than LDG (4.3 vs. 4.9
ABSTRACT Aim The National Clinical Database (NCD) of Japan is the largest nationwide registry, covering over 95% of surgeries in the country. This 2022 annual report summarizes the short‐term outcomes of gastroenterological surgeries and discusses trends and insights over the past decade. Methods We analyzed the NCD data for gastroenterological surgeries performed between 2013 and 2022. The number of surgeries, patient demographics, surgical approaches, postoperative outcomes, and the involvement of board‐certified surgeons and anesthesiologists were examined. Results A total of 591 221 surgeries were recorded in 2022. Compared to 2021, the overall surgical volume remained stable, with a continued increase in minimally invasive procedures. Patient aging continued across all organ categories, with a rise in the proportion of patients aged ≥ 80 years. Board‐certified surgeon participation remained high in complex procedures, while emergency surgeries were associated with higher morbidity and mortality. Operative mortality continued to decrease, particularly in pancreatic and hepatic surgeries. Conclusion The 2022 NCD data provide a comprehensive overview of the current status and evolving trends in gastroenterological surgery in Japan. Continued efforts toward data‐driven quality improvement and surgical education remain essential.
ABSTRACT Aim Minimally invasive surgery (MIS) is increasingly used for gastric cancer surgery. MIS is expected to facilitate surgical precision because of its magnified view, and facilitating identification of anatomical dissection layers is expected to reduce postoperative complications. To our knowledge, there is no consensus on the most appropriate surgical approach for gastric cancer following chemotherapy. Methods This nationwide, observational study used data from the National Clinical Database. Patients who underwent total gastrectomy (TG) or distal gastrectomy (DG) for gastric cancer after receiving chemotherapy between January 2014 and December 2022 were included. The incidence of overall complications of Clavien‐Dindo (CD) grade ≥ 1 was set as the primary outcome, and the risk ratio (RR) was estimated using inverse probability of treatment weighting based on propensity scores and G‐computation, comparing MIS and open surgery. The incidence of each complication was considered the secondary outcome. Results Overall, 18 100 patients were included in this study (TG, 9481; DG, 8619). MIS was associated with a lower incidence of overall complications of CD grade ≥ 1 in both TG (RR 0.91, 95% confidence interval [CI] 0.85–0.98) and DG (RR 0.78, 95% CI 0.72–0.84). MIS was also significantly associated with a lower incidence of superficial incisional surgical site infection (SSI), deep incisional SSI, and pancreatic fistulas in both gastrectomy groups. Conclusions MIS was associated with lower rates of overall postoperative complications of CD grade ≥ 1, and wound‐related complications and pancreatic fistulas than open surgery in patients with gastric cancer who underwent TG and DG after chemotherapy.
