尾内 善広

Abstract Background and Aim Changes in the number of surgeries for gastric cancer during the coronavirus disease 2019 (COVID‐19) pandemic have been reported, but data are insufficient to understand the impact at the national level. This study aimed to determine the impact of the COVID‐19 pandemic on gastric surgery in Japan. Methods Insurance claims data registered from January 2015 to January 2021 were used. Changes in the number of endoscopic resections and gastrectomies for gastric cancer were estimated using an interrupted time‐series analysis. Results The number of endoscopic resections significantly decreased in July 2020 (−1565; 95% confidence interval [CI]: −2022, −1108) and January 2021 (−539; 95% CI: −970, −109), and the number of laparoscopic surgeries significantly decreased in July 2020 (−795; 95% CI: −1097, −492), October 2020 (−313; 95% CI: −606, −19), and January 2021 (−507; 95% CI: −935, −78). Meanwhile, the number of open gastrectomies remained unchanged, and the number of robot‐assisted gastrectomies steadily increased since their coverage by public health insurance in April 2018. Conclusions The decreased number of endoscopic resections and laparoscopic surgeries in Japan suggests a decline in early‐stage gastric cancer diagnosis, likely due to the suspension of gastric cancer screening and diagnostic testing during the pandemic. Meanwhile, the number of open and robot‐assisted gastrectomies remained unchanged and increased, respectively, indicating that these applications were not affected by the pandemic‐related medical crisis. These findings highlight that procedures for cancer diagnosis, including screening, should still be provided during pandemics.

＜文献概要＞▼MIS-Cは,COVID-19に罹患した数週間後に発症する小児全身性炎症性症候群である.▼発熱と多臓器障害を呈するが,特にショックや心血管障害,腹部症状が特徴的である.▼川崎病に類似した症状を呈する症例も多く,冠動脈瘤合併例もある.▼川崎病の多い日本においては,鑑別診断が難しい症例がある.▼アジア人での発症頻度は少ない.日本における全国調査が4学会合同で行われている.▼日本独自の診断アルゴリズムの検討,冠動脈瘤予防に向けた治療の最適化などが課題である.