The clinical impact of COVID-19 on endoscopic surgery in Japan: Analysis of data from the National Clinical Database

Hidefumi Shiroshita; Hideki Endo; Masafumi Inomata; Tomonori Akagi; Hiroyuki Yamamoto; Shigeki Yamaguchi; Susumu Eguchi; Norihito Wada; Yukinori Kurokawa; Yosuke Seki; Yoshiharu Sakai; Hiroaki Miyata; Yoshihiro Kakeji; Yuko Kitagawa; Akinobu Taketomi; Masaki Mori

doi:10.1002/ags3.12660

The clinical impact of COVID-19 on endoscopic surgery in Japan: Analysis of data from the National Clinical Database

Ann Gastroenterol Surg. 2023 Feb 15;7(4):572-582. doi: 10.1002/ags3.12660. eCollection 2023 Jul.

Authors

Hidefumi Shiroshita^{1

2}, Hideki Endo³, Masafumi Inomata^{1

2}, Tomonori Akagi^{1

2}, Hiroyuki Yamamoto³, Shigeki Yamaguchi^{1

4}, Susumu Eguchi^{1

5}, Norihito Wada^{1

6}, Yukinori Kurokawa^{1

7}, Yosuke Seki^{1

8}, Yoshiharu Sakai^{1

9}, Hiroaki Miyata³, Yoshihiro Kakeji¹⁰, Yuko Kitagawa¹¹, Akinobu Taketomi¹², Masaki Mori¹³

Affiliations

¹ Academic Committee of Japan Society for Endoscopic Surgery Tokyo Japan.
² Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.
³ Department of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo Tokyo Japan.
⁴ Division of Colorectal Surgery, Department of Surgery Tokyo Women's Medical University Tokyo Japan.
⁵ Department of Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.
⁶ Department of Surgery Shonan Keiiku Hospital Fujisawa Kanagawa Japan.
⁷ Department of Gastroenterological Surgery Osaka University Graduate School of Medicine Osaka Japan.
⁸ Weight Loss and Metabolic Surgery Center Yotsuya Medical Cube Tokyo Japan.
⁹ Japanese Red Cross Osaka Hospital Osaka Japan.
¹⁰ Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine Kobe Hyogo Japan.
¹¹ Department of Surgery Keio University School of Medicine Tokyo Japan.
¹² Department of Gastroenterological Surgery I Hokkaido University Graduate School of Medicine Sapporo Hokkaido Japan.
¹³ The Japan Surgical Society Tokyo Japan.

Abstract

Aim: This study aimed to evaluate the impact of the coronavirus disease (COVID-19) pandemic on elective endoscopic surgeries in Japan using the National Clinical Database.

Methods: We retrospectively analyzed the clinicopathological factors and surgical outcomes of laparoscopic cholecystectomy (LC), laparoscopic distal gastrectomy (LDG), and laparoscopic low anterior resection (LLAR) and compared the monthly numbers of each procedure performed in 2020 with those in 2018 and 2019. The degree of infection in prefectures was classified into low and high groups.

Results: In 2020, the number of LCs (except for acute cholecystitis) was 76 079 (93.0% of that in 2019), the number of LDGs was 14 271 (85.9% of that in 2019), and the number of LLARs was 19 570 (88.1% of that in 2019). Although the number of robot-assisted LDG and LLAR cases increased in 2020, the growth rate was mild compared with that in 2019. There was little difference in the number of cases in the degree of infection in the prefectures. The numbers of LC, LDG, and LLAR cases decreased from May to June and recovered gradually. In late 2020, the proportion of T4 and N2 cases of gastric cancer and the number of T4 cases of rectal cancer increased compared with those in 2019. There was little difference between the proportions of postoperative complications and mortality in the three procedures between 2019 and 2020.

Conclusion: The number of endoscopic surgeries decreased in 2020 as a result of the COVID-19 pandemic. However, the procedures were performed safely in Japan.

Keywords: COVID‐19; National Clinical Database; endoscopic surgery; gastric cancer; rectal cancer.