| アブストラクト | OBJECTIVE: To examine the prevalence trends of minimally invasive hysterectomy for benign indications in Japan and investigate regional disparities. STUDY DESIGN: A retrospective cohort and ecological study using "The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data". SETTING: Nationwide Japan. PATIENTS: Individuals who underwent hysterectomy for benign indications from 2014 to 2020. INTERVENTIONS: Trend analysis of minimally invasive surgery (MIS) rates through laparoscopic hysterectomies (LH) and robotic-assisted laparoscopic hysterectomies (RA-LH) at the national and prefecture levels. Examination of regional factors contributing to the disparity in MIS implementation rates by second medical service area (SMSA). RESULTS: The number of LH has increased from 16,016 in 2014 to 27,755 in 2020. The nationwide MIS hysterectomy rate increased from 29% in 2014 to 55% in 2020 (p less than 0.001). More than 50% of hysterectomies have been performed as MIS since 2019. There was an increasing trend in MIS rates in all age groups. All prefectures except one showed a significant upward trend (p less than 0.05) in the MIS rates, but MIS rates varied widely (23-84%). In a multivariable model, the MIS was more likely to be performed in the SMSAs in western Japan (p = 0.011), in the SMSAs where the number of laparoscopy-qualified gynecologists is 5-10 (p = 0.013), and 11 or higher (p less than 0.001). CONCLUSIONS: This study reveals a shift towards minimally invasive surgery (MIS) in total hysterectomy procedures in Japan. However, significant disparities in the prevalence of MIS hysterectomy exist, potentially influenced by the number of laparoscopy-qualified gynecologists. |
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| 投稿者 | Isoyama, Kyoko; Matsuura, Motoki; Hayasaka, Misa; Nagao, Sachiko; Nishimura, Yoko; Yoshioka, Toshiki; Imai, Yuichi; Miyagi, Etsuko; Suzuki, Yukio; Saito, Tsuyoshi |
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| 組織名 | Department of Gynecology, Sapporo Medical University, 291, West 16, South 1,;Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan.;Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan. Electronic address:;mmatsuura@sapmed.ac.jp.;Department of Obstetrics and Gynecology, Asahikawa Medical University,;Midorigaokahigashi 2-1-1-1, Asahikawa, Hokkaido 078-8510, Japan.;Department of Obstetrics and Gynecology, Yokohama City University Graduate School;of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan.;Division of Gynecologic Oncology, Department of Obstetrics and Gynecology,;Columbia University Vagelos College of Physicians and Surgeons, New York, NY,;USA. Electronic address: yetii@yokohama-cu.ac.jp. |
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