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

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)572-582
Number of pages11
JournalAnnals of Gastroenterological Surgery
Issue number4
Publication statusPublished - 2023 Jul


  • COVID-19
  • National Clinical Database
  • endoscopic surgery
  • gastric cancer
  • rectal cancer

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


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