| アブストラクト | BACKGROUND: Mediastinal tumor surgery and extended thymectomy for myasthenia gravis (MG) have undergone significant changes with the advancement of minimally invasive techniques. However, nationwide population-based data capturing these trends in Japan remain limited. This study aimed to characterize national surgical trends for mediastinal tumors and MG using a comprehensive administrative claims database. METHODS: We analyzed data extracted from the National Database of Health Insurance Claims and Specific Health Checkups (NDB), covering over 95% of insured procedures in Japan. We classified surgeries from 2014 to 2023 by disease category (benign tumor/malignant tumor/MG) and approach (open/thoracoscopic/robotic-assisted). Crude and age-standardized surgery rates were calculated per 100,000 person-years. Temporal trends were assessed using linear and Poisson regression models. RESULTS: In 2023, a total of 6214 surgeries was performed: 54.4% for benign tumors, 41.6% for malignant tumors, and 4.0% for MG. Thoracoscopic approaches accounted for 76.4% of all procedures (29.4% robotic-assisted), while open surgery comprised 23.6%. Over the decade, age-standardized overall mediastinal tumor surgeries increased significantly (P = 0.0001), driven by marked rises in malignant, thoracoscopic, and robotic-assisted surgeries (each P < 0.0001). In contrast, extended thymectomies and open surgeries declined (P = 0.0019, and < 0.0001, respectively). Age-standardized malignant tumor surgery rates rose in both sexes (relative risk = 1.051 for males, 1.065 for females, and 1.058 overall; P < 0.0001), especially among those aged >/= 40 years in both sexes (P < 0.0024). CONCLUSION: This nationwide study reveals growing surgical demand for mediastinal tumors and underscores the widespread adoption of minimally invasive techniques. |
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| 投稿者 | Kido, Masamitsu; Okada, Satoru; Furuya, Tatsuo; Ishihara, Shunta; Uchibori, Atsuki; Kameyama, Kenji; Kakibuchi, Daichi; Tsujikawa, Takahiro; Yoshii, Kengo; Shoda, Katsutoshi; Ishii, Ryotaro; Matsui, Naoko; Kido, Tetsuo; Inoue, Masayoshi |
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| 組織名 | Department of Orthopedic Surgery, Inage Hospital, 6-21-3 Konakadai, Inage-ku,;Chiba, 2630043, Japan.;Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical;Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho,;Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 6028566, Japan.;s-okada@koto.kpu-m.ac.jp.;Department of General Thoracic Surgery, Japanese Red Cross Kyoto Daiichi;Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 6050981, Japan.;Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University;of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 6028566,;Japan.;Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural;University of Medicine, 1-5 Shimogamo Hangi-cho, Sakyo-ku, Kyoto, 6060823, Japan.;First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110;Shimokato, Chuo, Yamanashi, 4093898, Japan.;Department of Neurology, Kyoto Prefectural University of Medicine, 465 Kajii-cho,;Department of Neurology, Tokushima University Graduate School of Biomedical;Sciences, 5-50-1 Kuramoto, Tokushima, 7708503, Japan.;Department of Thoracic Surgery, TOHO Yao Hospital, Osaka, 5810802, Japan. |
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