{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:48:32Z","timestamp":1787582912593,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The use of minimally invasive surgery, including laparoscopic and robotic surgery, for gastrointestinal cancer has been rapidly increasing. This study aimed to clarify whether differences in minimally invasive surgery outcomes are associated with regional and patient characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 123\u2009771 right hemicolectomy and 126\u2009965 low anterior resection cases performed between 2013 and 2019 were selected from the National Clinical Database for analysis. Patients were stratified by regional and economic variables, and open and minimally invasive surgical outcomes were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In secondary medical regions characterized by urban settings and numerous designated cancer care hospitals, the observed 30\u2010day mortality of low anterior resections was lower only in the minimally invasive surgery group. For right hemicolectomies in regions with many designated cancer care hospitals, the observed incidence of postoperative complications was also lower in the minimally invasive group. Residents of high\u2010income areas undergoing low anterior resection had a lower frequency of 30\u2010day reoperation regardless of the type of surgery and a lower 30\u2010day mortality in the minimally invasive group. For both right hemicolectomy and low anterior resection, patients with longer travel distances had fewer postoperative complications and lower 30\u2010day reoperation rates in the minimally invasive group than in the open surgery group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study found regional and patient characteristic disparities in minimally invasive surgical outcomes; national policies should be implemented to address these inequities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ags3.70007","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T19:44:07Z","timestamp":1743795847000},"page":"769-784","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5535-3514","authenticated-orcid":false,"given":"Atsushi","family":"Hamabe","sequence":"first","affiliation":[{"name":"Department of Surgery, Surgical Oncology and Science Sapporo Medical University  Sapporo Japan"},{"name":"Department of Gastroenterological Surgery, Graduate School of Medicine Osaka University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arata","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, School of Medicine Keio University  Tokyo Japan"},{"name":"Department of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiraku","family":"Kumamaru","sequence":"additional","affiliation":[{"name":"Department of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1545-0509","authenticated-orcid":false,"given":"Hiroshi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine Kobe University  Kobe Japan"},{"name":"Project Management Subcommittee, The Japanese Society of Gastroenterological Surgery  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koki","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Project Management Subcommittee, The Japanese Society of Gastroenterological Surgery  Tokyo Japan"},{"name":"Department of Advanced Robotic and Endoscopic Surgery Fujita Health University School of Medicine  Toyoake 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