{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:28:31Z","timestamp":1790947711318,"version":"4.1.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T00:00:00Z","timestamp":1570060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T00:00:00Z","timestamp":1570060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Esophagus"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>In 2009, the Japan Esophageal Society (JES) established a system for certification of qualified surgeons as \u201cBoard Certified Esophageal Surgeons\u201d (BCESs) or institutes as \u201cAuthorized Institutes for Board Certified Esophageal Surgeons\u201d (AIBCESs). We examined the short-term outcomes after esophagectomy, taking into consideration the certifications statuses of the institutes and surgeons.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This study investigated patients who underwent esophagectomy for thoracic esophageal cancer and who were registered in the Japanese National Clinical Database (NCD) between 2015 and 2017. Using hierarchical multivariable logistic regression analysis adjusted for patient-level risk factors, we determined whether the institute\u2019s or surgeon\u2019s certification status had greater influence on surgery-related mortality or postoperative complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Enrolled were 16,752 patients operated on at 854 institutes by 1879 surgeons. There were significant differences in the backgrounds and incidences of postoperative complications and surgery-related mortality rates between the 11,162 patients treated at AIBCESs and the 5590 treated at Non\u2013AIBCESs (surgery-related mortality rates: 1.6% vs 2.8%). There were also differences between the 6854 patients operated on by a BCES and the 9898 treated by a Non-BCES (1.7% vs 2.2%). Hierarchical logistic regression analysis revealed that surgery-related mortality was significantly lower among patients treated at AIBCESs. The institute\u2019s certification had greater influence on short-term surgical outcomes than the operating surgeon\u2019s certification.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The certification system for surgeons and institutes established by the JES appears to be appropriate, as indicated by the improved surgery-related mortality rate. It also appears that the JES certification system contributes to a more appropriate medical delivery system for thoracic esophageal cancer in Japan.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s10388-019-00694-9","type":"journal-article","created":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T06:03:31Z","timestamp":1570082611000},"page":"41-49","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Impact of certification status of the institute and surgeon on short-term outcomes after surgery for thoracic esophageal cancer: evaluation using data on 16,752 patients from the National Clinical Database in Japan"],"prefix":"10.1007","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9191-2563","authenticated-orcid":false,"given":"Satoru","family":"Motoyama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Miyata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Yano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takushi","family":"Yasuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaichi","family":"Ohira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Kajiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Toh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Kakeji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Seto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Doki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisahiro","family":"Matsubara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,3]]},"reference":[{"key":"694_CR1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10388-018-0614-z","volume":"15","author":"Y Tachimori","year":"2018","unstructured":"Tachimori Y, Ozawa S, Numasaki H, et al. Registration Committee for\u00a0Esophageal Cancer\u00a0of the\u00a0Japan\u00a0Esophageal\u00a0Society. Comprehensive\u00a0Registry\u00a0of\u00a0Esophageal Cancer\u00a0in\u00a0Japan, 2011. Esophagus. 2018;15:127\u201352.","journal-title":"Esophagus"},{"key":"694_CR2","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1007\/s10388-018-0646-4","volume":"16","author":"S Motoyama","year":"2019","unstructured":"Motoyama S, Maeda E, Yano M, et al. Appropriateness of the institute certification system for esophageal surgeries by the Japan Esophageal Society. Evaluation of survival outcomes using data from the National Database of Hospital-based Cancer Registries in Japan. Esophagus. 2019;16:114\u201321.","journal-title":"Esophagus"},{"key":"694_CR3","doi-asserted-by":"publisher","first-page":"e0193186","DOI":"10.1371\/journal.pone.0193186","volume":"13","author":"H Miyata","year":"2018","unstructured":"Miyata H, Mori M, Kokudo N, et al. 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Int J Clin Oncol. 2018;23:81\u201391.","journal-title":"Int J Clin Oncol."}],"container-title":["Esophagus"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10388-019-00694-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s10388-019-00694-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10388-019-00694-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T23:53:53Z","timestamp":1601596433000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s10388-019-00694-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,3]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["694"],"URL":"https:\/\/doi.org\/10.1007\/s10388-019-00694-9","relation":{},"ISSN":["1612-9059","1612-9067"],"issn-type":[{"value":"1612-9059","type":"print"},{"value":"1612-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,3]]},"assertion":[{"value":"28 May 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 October 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The use of data from the registry for retrospective observational studies was approved by JSGS and JES. This study was approved by the institutional ethics board of Akita University Graduate School of Medicine (No. 1919).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Statement"}},{"value":"There are no financial or other relations that could lead to a conflict of interest regarding this study. Hiroyuki Yamamoto and Hiroaki Miyata are affiliated with the Department of Healthcare Quality Assessment at the University of Tokyo. The department is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson K.K., and Nipro Co.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}