{"title":"A Case of Robot-Assisted Pylorus-Preserving Pancreatoduodenectomy for Branch-Duct Intraductal Papillary Mucinous Neoplasms Complicated With an Annular Pancreas","authors":"Aoi Hayasaki, Naohisa Kuriyama, Miki Usui, Motonori Nagata, Benson Kaluba, Tatsuya Sakamoto, Haruna Komatsubara, Koki Maeda, Toru Shinkai, Daisuke Noguchi, Takahiro Ito, Kazuyuki Gyoten, Takehiro Fujii, Yusuke Iizawa, Akihiro Tanemura, Yasuhiro Murata, Masashi Kishiwada, Shugo Mizuno","doi":"10.1111/ases.70022","DOIUrl":"10.1111/ases.70022","url":null,"abstract":"<p>Annular pancreas is a rare congenital anatomical anomaly, in which the pancreatic parenchyma surrounds the descending duodenum. Generally, annular pancreas is diagnosed on the basis of symptoms associated with complications of peptic ulcer, pancreatitis, cholelithiasis, and rarely, malignant tumors. Herein, we report an 84-year-old man for whom, during hospitalization for a urinary tract infection, pancreatic cystic lesions and an annular pancreas were noted incidentally on computed tomography. These findings led to a diagnosis of intraductal papillary mucinous neoplasms on further examination. He safely underwent robot-assisted pylorus-preserving pancreatoduodenectomy, with an operative time of 478 min and blood loss of 37 g. He was discharged on postoperative day 8 without postoperative complications. In conclusion, it is important to note that, in this case, intraductal papillary mucinous neoplasms were detected before they became malignant, and minimally invasive surgery was performed safely despite the anatomical anomaly of an annular pancreas.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thoracoscopic Lobectomy for Right Upper Bronchial Atresia Combined With an Azygos Lobe of the Right Lower Lobe in an Infant Patient: A Case Report of a Rare Condition","authors":"Nanako Nishida, Keisuke Yano, Yumiko Tabata, Chihiro Kedoin, Ayaka Nagano, Toshio Harumatsu, Yudai Tsuruno, Masakazu Murakami, Koshiro Sugita, Shun Onishi, Koji Yamada, Waka Yamada, Takafumi Kawano, Satoshi Ieiri","doi":"10.1111/ases.70019","DOIUrl":"10.1111/ases.70019","url":null,"abstract":"<p>Bronchial atresia (BA) and azygos lobe (AL) are rare congenital pulmonary abnormalities in pediatric patients. We herein report an infantile case of BA combined with AL that was treated with thoracoscopic surgery. The patient was an 8-month-old boy who was preoperatively diagnosed with BA of the right upper lobe (RUL) combined with an AL using fetal magnetic resonance imaging and postnatal enhanced computed tomography. Thoracoscopic surgery using indocyanine green (ICG)-guided near-infrared fluorescence (NIRF) was performed for BA of the RUL. In the operative findings, the upper lobe bronchus was not recognized, and the pulmonary vessels of the RUL were confirmed using ICG-guided NIRF. The AL was connected to the right lower lobe (RLL). Partial RLL, including AL resection, was performed after RUL resection to prevent postoperative infections and torsion. The postoperative course was uneventful. Thoracoscopic surgery using ICG-guided NIRF was safely performed in an infant with a rare condition.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Two-Site Thoracoscopic Surgery for Extra-Pulmonary Sequestration Using an Extraction Wound: Five Pediatric Cases With Favorable Cosmetic Outcomes","authors":"Keisuke Yano, Nanako Nishida, Chihiro Kedoin, Yumiko Tabata, Yumiko Iwamoto, Masato Ogata, Lynne Takada, Ayaka Nagano, Yudai Tsuruno, Masakazu Murakami, Koshiro Sugita, Shun Onishi, Toshio Harumatsu, Takafumi Kawano, Mitsuru Muto, Tatsuru Kaji, Satoshi Ieiri","doi":"10.1111/ases.70005","DOIUrl":"10.1111/ases.70005","url":null,"abstract":"<p>Many institutions perform thoracoscopic surgery for pediatric extrapulmonary sequestration (EPS). This approach achieves good cosmetic outcomes due to the small skin incision in comparison to open surgery. However, an extension or additional incision is sometimes necessary to extract resected specimens from the thoracic cavity, which reduces the advantages of this procedure. We herein report 5 cases of two-site thoracoscopic surgery (TTS) using an extraction wound with left-sided EPS. In this procedure, a camera port was inserted inside the skin incision at the sixth intercostal space of the middle axillary line using optical methods, and the operator's left-hand port was inserted inside the same skin incision. The EPS was resected and extracted through a skin incision without extension or additional incision. A surgeon-in-training performed the procedure in 4 of the 5 cases. The postoperative course was uneventful in all cases. The patients showed quick recovery and good cosmetic outcomes. TTS is a cosmetically favorable approach for EPS.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advantages of Robotic Total Mesorectal Excision With Partial Prostatectomy Compared With Open Surgery for Rectal Cancer: A Single-Center Retrospective Cohort Study","authors":"Rumi Shimano, Shunsuke Kasai, Hiroyasu Kagawa, Akio Shiomi, Shoichi Manabe, Yusuke Yamaoka, Yusuke Tanaka, Takahiro Igaki, Akitoshi Nankaku, Yusuke Kinugasa","doi":"10.1111/ases.70003","DOIUrl":"10.1111/ases.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Robotic total mesorectal excision (TME) with resection of adjacent organs has been increasingly used for locally advanced rectal cancer; however, few studies have focused on robotic TME with partial prostatectomy. Therefore, this study aimed to demonstrate the advantages of robotic TME with partial prostatectomy compared with open surgery for rectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This retrospective cohort study examined consecutive patients with rectal cancer who underwent robotic or open TME with partial prostatectomy at a high-volume center in Japan from April 2003 to March 2022. The patients were divided into robotic (<i>n</i> = 14) and open (<i>n</i> = 11) surgery groups. The short- and long-term outcomes of these patients were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More transabdominal partial prostatectomies were performed in the robotic surgery group than in the open surgery group (71.4% vs. 9.1%, <i>p</i> = 0.001). Moreover, sphincter-preserving surgery was performed in 35.7% of patients in the robotic surgery group. The robotic surgery group had shorter operative times (401 min vs. 435 min, <i>p</i> = 0.047), less blood loss (56 mL vs. 484 mL, <i>p</i> < 0.001), lower complication rates (28.6% vs. 72.7%, <i>p</i> = 0.047), and shorter postoperative hospital stays (8 days vs. 18 days, <i>p</i> < 0.001) than the open surgery group. No significant differences were observed in the positive radial margin rate (7.1% vs. 9.1%, <i>p</i> = 1.000) or long-term outcomes between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared with open surgery, robotic TME with partial prostatectomy facilitates transabdominal partial prostatectomy, resulting in more sphincter-preserving surgeries and better short-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cervical-First Approach in Thoracoscopic Esophagectomy With Intraoperative Nerve Monitoring for an Esophageal Cancer Patient With Aberrant Right Subclavian Artery","authors":"Masato Mochizuki, Shigeru Tsunoda, Shintaro Okumura, Tatsuto Nishigori, Shigeo Hisamori, Keiko Kasahara, Takashi Sakamoto, Hiromitsu Kinoshita, Yoshiro Itatani, Nobuaki Hoshino, Ryosuke Okamura, Hisatsugu Maekawa, Koya Hida, Kazutaka Obama","doi":"10.1111/ases.70018","DOIUrl":"10.1111/ases.70018","url":null,"abstract":"<div>\u0000 \u0000 <p>An aberrant right subclavian artery (ARSA) is a rare vascular anomaly accompanied by nonrecurrent inferior laryngeal nerve (NRILN). Here, we described the cervical-first approach in thoracoscopic esophagectomy for an esophageal cancer patient with ARSA using the intraoperative nerve monitoring (IONM) system. First, a left cervical procedure proceeded to expose the left vagus nerve to attach the APS electrode of the IONM system, and the left cervical paraesophageal lymph nodes was dissected separately. Subsequently, the NRILN was identified using the IONM system by tracing the right vagal nerve with intermittent manual stimulation. In the thoracoscopic procedures, the right vagal nerve was traced cranially from the bronchial bifurcation, and the dissection continued through the cervicothoracic border up to NRILN without difficulty. Continuous nerve monitoring can ensure safe left upper mediastinal dissection ensuring the left recurrent laryngeal nerve integrity in the narrow upper mediastinum. The postoperative course was uneventful and, the patient was discharged on postoperative Day 21. In patients with ARSA, the cervical-first method in thoracoscopic esophagectomy with IONM is a safer alternative, and left upper mediastinal dissection by the dorsal approach over the esophagus is useful in the restricted space of the upper mediastinum.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sentinel Lymph Node Detection Using SPECT and Gamma Probe in Low-Risk Endometrial Cancer: Efficacy and Factors Associated With Detection Failure","authors":"Kazuo Asanoma, Hideaki Yahata, Keisuke Kodama, Kaoru Okugawa, Masafumi Yasunaga, Ichiro Onoyama, Hiroshi Yagi, Shoji Maenohara, Kazuhisa Hachisuga, Takuro Isoda, Mototsugu Shimokawa, Kousei Ishigami, Yoshinao Oda, Kiyoko Kato","doi":"10.1111/ases.70015","DOIUrl":"10.1111/ases.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study examined factors that affected sentinel lymph node (SLN) identification of patients with endometrial cancer having a preoperative estimation of low recurrent risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 97 patients with endometrial cancer who attempted to identify SLN using a uterine cervical injection of technetium-99 m phytate under laparoscopic or robotic-assisted surgery at our institute. A preoperative single photon emission computed tomography (SPECT) and intraoperative gamma probe were used to detect hot nodes. Multiple clinical factors, including age, body mass index (BMI), and so on, were investigated for their association with SLN mapping failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 97 cases, SPECT failed to detect SLN unilaterally in 38 cases (39%) and on both sides in 9 cases (9%). Meanwhile, the gamma probe failed to detect SLN unilaterally in 23 cases (24%) and on both sides in 3 cases (3%). While only age was significantly associated with SLN detection failure using the SPECT detection system, both age and BMI were significantly associated with SLN detection failure using the gamma probe detection system. When limiting to the preoperative SLN detection failure cohort of 47 cases, there was a strong association between intraoperative SLN detection failure and BMI, but not age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The SLN biopsy system was effectively applied to patients with endometrial cancer who underwent minimally invasive surgery (MIS). Attempts to improve SLN identification in older patients and those with obesity are warranted to obtain maximum benefits of MIS for low- or medium-risk cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preoperative Indocyanine Green Tattooing for Robotic-Assisted Surgery in Rectal Cancer","authors":"Yoshihiro Morimoto, Akihiro Kobayashi, Nobuyoshi Yamazaki, Kouichirou Kubo, Manabu Satou, Ryousuke Kobayashi, Daichi Asai, Kouta Akamine, Kenji Ogata","doi":"10.1111/ases.70010","DOIUrl":"10.1111/ases.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Preoperative identification of the site of rectal cancer surgery is crucial for ensuring accurate tumor localization and resection. Commonly employed methods include contrast-enhanced enterography and endoscopic marking techniques, such as clipping and India ink tattooing. However, India ink tattooing poses challenges, including obstruction of the surgical field, ink leakage into the abdominal cavity, and potential complications such as peritonitis and adhesive bowel obstruction. Similarly, clipping requires palpation, making minimally invasive procedures, such as laparoscopic or robotic-assisted surgery, impractical.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>The indocyanine green fluorescence method is employed intraoperatively to monitor blood and lymph flow in the intestinal tract. Here, we discuss the effectiveness of preoperative indocyanine green marking in accurately locating tumors during robot-assisted rectal colorectal surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>By using the fluorescence properties of indocyanine green, surgeons can precisely identify the tumor site, overcoming the limitations of traditional methods. This technique improves surgical accuracy while minimizing intraoperative risks and achieving optimal oncological outcomes. Preoperative indocyanine green tattooing represents a valuable enhancement to current techniques in rectal cancer surgery, particularly for robot-assisted approaches. Our findings underscore the applicability of preoperative indocyanine green tattooing as a promising alternative in robot-assisted surgery for patients with rectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic Anatomical Liver Resection for the Patients With Constitutional Indocyanine Green Excretory Defect: A Case Report","authors":"Takanori Morikawa, Yuta Wakui, Yasuhiro Hasegawa, Norihiko Sugisawa, Shunichi Kimura, Tomoaki Hirashima, Makoto Kinouchi, Hajime Iwasashi","doi":"10.1111/ases.13415","DOIUrl":"10.1111/ases.13415","url":null,"abstract":"<div>\u0000 \u0000 <p>Constitutional indocyanine green (ICG) excretion defect (CIED) is a rare clinical condition characterized by markedly delayed ICG disappearance with other normal liver function tests. Here, we report a case of CIED in which laparoscopic anatomical liver resection was successfully performed using ICG fluorescence staining. A 64-year-old man with a 4-cm tumor located in the liver segment 5 was referred to our hospital. His ICG retention rate at 15 min was 70%, but other liver function tests including <sup>99m</sup>Tc-galactosyl human serum albumin scintigraphy were normal. We then planned laparoscopic segmentectomy under the diagnosis of hepatocellular carcinoma and suspected CIED. Laparoscopic hepatectomy was started after confirming a histologically normal liver. After clamping the Glissonean pedicle of segment 5, ICG was injected and the demarcation line was identified. Liver dissection was performed along the demarcation line and the operation was completed. The patient was discharged on postoperative day 10 without any complications.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sciatic Nerve Preservation in Robot-Assisted Surgery for Initially Unresectable Primary Rectal Cancer: A Case Report","authors":"Ryosuke Mizuno, Ryosuke Okamura, Yoshiro Itatani, Hiromitsu Kinoshita, Yuki Aisu, Hisatsugu Maekawa, Nobuaki Hoshino, Koya Hida, Kazutaka Obama","doi":"10.1111/ases.70013","DOIUrl":"10.1111/ases.70013","url":null,"abstract":"<div>\u0000 \u0000 <p>Radical surgery for rectal cancer with bulky lateral pelvic lymph node (LPLN) metastasis involving the sciatic nerve presents both technical and oncological challenges. Preoperative multidisciplinary treatments have recently been anticipated to control the disease as well as to preserve organ function. A 51-year-old man, presenting with right buttock pain and impairment of walking, was diagnosed with sciatic nerve impairment due to right LPLN metastasis from rectal cancer. He was initially treated with palliative radiotherapy followed by FOLFOX plus bevacizumab. After 13 cycles of the chemotherapy, his symptoms disappeared and the LPLN shrank. Then, conversion surgery via robot-assisted low anterior resection with right LPLN dissection was performed. Although he had moderate right leg pain postoperatively, there were no motor deficits or other complications. Pathological examination of the specimen revealed microscopic residual disease at the resection margin, but he is currently surviving recurrence-free for 1.5 years. Preoperative multidisciplinary treatment enabled the preservation of the sciatic nerve in the robot-assisted conversion surgery.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of Short-Term Outcomes of Colorectal Cancer Surgery Performed by Male and Female Surgeons: A Japanese Multicenter Study","authors":"Rika Ono, Tetsuro Tominaga, Takashi Nonaka, Toshio Shiraishi, Shintaro Hashimoto, Keisuke Noda, Masato Araki, Yorihisa Sumida, Hiroaki Takeshita, Hidetoshi Fukuoka, Shosaburo Oyama, Kazuhide Ishimaru, Keitaro Matsumoto","doi":"10.1111/ases.70017","DOIUrl":"10.1111/ases.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The number of female doctors is increasing worldwide, but the percentage of female general surgeons and gastrointestinal surgeons remains low, at only 6% in Japan. Furthermore, in rural areas, the number of doctors is small and training opportunities are limited, and training in surgical techniques is reportedly inadequate compared with urban areas. This study examined the current status and surgical outcomes of colorectal cancer surgery by surgeon sex using a multicenter database in a Japanese rural area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 3440 consecutive patients who underwent laparoscopic colorectal surgery in six participating hospitals between April 2016 and March 2023. Clinical and perioperative outcomes were compared between patients who underwent surgery by a male surgeon (M group; <i>n</i> = 3142) or by a female surgeon (F group; <i>n</i> = 298).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Years of experience as a doctor was significantly shorter (M group vs. F group: 12 years vs. 9 years, <i>p</i> < 0.001), frequency of participation of an expert surgeon was higher (79.9% vs. 89.9%, <i>p</i> = 0.038), frequency of preoperative treatment was lower (8.2% vs. 2.3%, <i>p</i> < 0.001), clinical <i>T</i> status was lower (<i>p</i> = 0.011), and re-operation rate was lower (3.1% vs. 1.0%, <i>p</i> = 0.045) in the F group. Multivariate analysis of clinical factors predicting postoperative severe complications revealed comorbidities (odds ratio 1.442, 95% confidence interval 1.045–1.990, <i>p</i> = 0.025) as an independent predictor of severe postoperative complications but not the presence of a female surgeon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Female surgeons in our study achieved comparable short-term outcomes to male surgeons, including for laparoscopic procedures. Establishing an educational system in rural areas could provide improved surgical techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}