Department of Digestive Tract and General Surgery

Introduction

In the Department of Digestive Tract and General Surgery, the motto is "sufficient explanation for the patients and treatment by specialists with no complications," and we are focusing on surgical treatment of malignant tumors of the gastrointestinal tract and benign diseases. A characteristic of our department is to practice treatments in a wide range of areas while maintaining a high level of expertise.

[Surgical treatment/multidisciplinary medical treatment of gastrointestinal cancers]

For esophageal cancer, gastric cancer, and colorectal cancer, we actively introduce minimally invasive treatments such as endoscopic treatments (in conjunction with the Department of Gastroenterology and Hepatology) and laparoscopic surgery in response to the progression, and we strive to improve the quality of life of our patients. When it is not possible to treat with routine surgery, we aim for cures in combination with extended surgery, chemotherapy and radiotherapy (in cooperation with the Department of Radiation Oncology). In terms of function preservation, we actively aim to preserve digestive tract function after gastric cancer resections and preserve the anus in surgery for lower rectal cancers. For recurrent lesions of gastric cancer and colorectal cancer, we aim to reduce the lesions by using combinations that include effective chemotherapy and aim to heal by actively performing liver metastasis resections.

[Surgical treatment for benign diseases]

We also provide surgical treatment for relatively infrequent diseases such as esophageal achalasia, esophageal hiatus hernia, and inflammatory bowel diseases (ulcerative colitis, Crohn's disease), etc. There are also numerous surgeries in the general surgical areas such as inguinal hernia, acute appendicitis, benign anal diseases (hemorrhoids, anal fistulas, anal fissures, anal prolapse), etc.

[Cancer genetic medicine and hereditary colorectal cancer]

Chemotherapy is central to the treatment of malignant tumors of the gastrointestinal tract that cannot be cured by endoscopic or surgical treatment. A number of genes in the tumor are examined to select the optimal treatment (such as the choice of chemotherapy), and we will drive the so-called cancer genome medicine. Genetic diagnosis, surgical treatment, and long-term follow-up of hereditary colorectal cancer (such as familial colorectal adenomas and Lynch syndrome) have been performed aggressively, and many patients from all over the country have been visiting us.

Patient care at our department

[Outpatient care]

Initial consultation:

For the initial consultation, please consult with a stuff in charge of surgery outpatients on the first floor in mornings from Monday to Friday where possible.
The reception desk hours are from 8:00am to 11:00am. The examination start time is 9:00am. It is preferable to bring a letter of referral, but it is fine if you don't have one. It is possible to receive a checkup on the day of the doctor's follow-up examination as a new patient.
If you are a new patient and need to be hospitalized, the outpatient staff may explain the flow for hospitalization, or may introduce you to the admission and discharge support office if necessary.
In addition, transferring to a ward will be performed by the outpatient medical director. As a result of the entire examination at the clinic, the treatment policy, and in particular the operative type of surgery may be different from the content described in the outpatient department, but in that case, we will explain in detail after admission.

Return visits:

Each organ specialist will be responsible for the post-operative follow-up and chemotherapy. Chemotherapy is available at the outpatient chemotherapy center.

[Unique outpatient]

At unique specialist outpatient, we provide appropriate medical information (such as selection of treatment methods) and genetic diagnosis for hereditary colorectal cancers such as familial colorectal adenomas (colorectal polyposis) and Lynch syndrome. You must be counseled by a certified genetic counselor when you undergo a genetic diagnosis. Where possible, please bring a letter of referral.

[Inpatient care]

The medical clinic is divided into three to four teams, practicing the most important team medicine in the surgical practice. The team rounds will be done every morning from 8:30am. The explanation before treatment and obtaining the consent form for treatment is usually done after hospitalization. The daily treatment is done by a surgical team, but we have all of the staff of the treatment departments participate in a conference (twice a week) and the general manager does rounds (once a week). Through these procedures, we examine the conditions of the hospitalized patients, confirm the treatment policy, and examine any changes. The staff of the medical department will work together to provide the best treatment for the patients. We are striving every day.

Main diseases

• Esophageal cancer
• Gastric cancer
• Small intestine cancer
• Colorectal (colon, rectal, anal) cancer
• Metastatic liver cancer (colorectal cancer, gastric cancer, etc.)
• Inflammatory bowel disease (ulcerative colitis, Crohn's disease, intestinal Behcet's disease)
• Familial colorectal adenomatosis (familial colorectal polyposis)
• Peutz‐Jeghers' syndrome
• Juvenile polyposis syndrome
• Lynch syndrome
• Acute appendicitis
• Strangulation ileus
• Adhesive ileus
• Idiopathic esophageal rupture
• Upper gastrointestinal tract (stomach, duodenum) perforation
• Colorectal perforation
• Anal disease (internal hemorrhoids, anal fistula, perianal abscess, anal fissure)
• Anal prolapse/rectal prolapse
• Hernia (inguinal, groin, abdominal wall scar, etc.)

Target Symptoms

Esophageal cancer:

Difficulty swallowing, weight loss, chest pain, back pain, hoarse voice, bloody sputum

Gastric cancer:

Epigastric discomfort, heartburn, nausea, loss of appetite, anemia, black stool

Colorectal cancer:

Bloody stool, narrowing of stool, feeling of constipation, abdominal bloating, abdominal pain, anemia, weight loss

Metastatic liver cancer:

A lump in the right hypocondrium, abdominal pain

Ulcerative colitis:

Bloody stool/mucous and blood in stool, diarrhea, hematogenous diarrhea, abdominal pain, fever, loss of appetite, weight loss, anemia

Crohn's disease

Abdominal pain, diarrhea, weight loss, fever, anal fistula, intestinal obstruction, intestinal perforation

Familial adenomatous polyposis:

Lots of polyps in the stomach and large intestine.

Lynch syndrome:

Large number of relatives with colorectal cancer and uterine body cancer

Acute appendicitis:

Fever, right lower abdominal pain

Ileus:

Abdominal pain, vomiting, no bowel movement or passing gas.

Gastrointestinal perforation:

Abdominal pain (sharp pain), fever

Hemorrhoid

Bleeding and pain during bowel movements

Anal prolapse:

Stool leakage, difficulty in defecation, discomfort in the lower abdomen, difficulty urinating.

Inguinal hernia:

Protruding inguinal bulge, inguinodynia

Treatment results

Medical staff

Name	Job Title	Position	Specialized Field	Credentials
石田　秀行 (Ishida Hideyuki)	Professor	Chief of Clinical Services	General Surgery (Colorectlal surgery) Hereditary colorectal cancerCancer Chemotherapy	Board Certified Surgeon (Jpn Surg Assoc, Jpn Soc Gastroenterolo Surg) Faculty(tentative), Subspecialty Board of Medical Oncology, JSMO
熊谷　洋一 (Kumagai Yoichi)	Professor	Vice-Chief of Clinical Services Manager of Residency Programs Chief of Education	General Surgery (Gastric surgery) Endoscopic surgery	Board Certified Surgeon (Jpn Surg Assoc, Jpn Soc Gastroenterolo Surg) Endoscopic surgical skill qualification system: qualified surgeon (Jpn Soc Enodsc Surg)
松山　貴俊 (Takatoshi Matsuyama)	Associate Professor	Manager of Inpatient Services	General Surgery (Colorectlal surgery)	Board Certified Surgeon (Jpn Surg Assoc, Jpn Soc Gastroenterolo Surg) Endoscopic surgical skill qualification system: qualified surgeon (Jpn Soc Enodsc Surg) Board Certified Fellow (Jpn Soc Gastroenterologocal Endosc)
石畝　亨 (Ishiguro Toru)	Associate Professor	Manager of Outpatient Services	General Surgery(Esophagp-Gastric Surgery) Endoscopic Surgery	Board Certified Surgeon (Jpn Surg Assoc, Jpn Soc Gastroenterolo Surg) Endoscopic surgical skill qualification system: qualified surgeon (Jpn Soc Enodsc Surg)
幡野　哲 (Hatano Satoshi)	Associate Professor Lecturer		General Surgery(Colorectal Surgery)	Board Certified Surgeon(Jpn Surg Assoc, Jpn Soc Gastroenterol Surg) Board Certified Fellow (Jpn Soc Gastroenterologocal Endosc)
近　範泰 (Chika　Noriyasu)	Associate Professor Lecturer	Chief of Research	General Surgery(Colorectal Surgery)	Board Certified Surgeon(Jpn Surg Assoc Jpn Soc Gastroenterol Surg)
伊藤　徹哉 (Itou Tetsuya)	Instructor	Vice-Chief of Education	General Surgery(Esophagp-Gastric Surgery) Endoscopic Surgery	Board Certified Surgeon(Jpn Surg Assoc, Jpn Soc Gastroenterol Surg) Board Certified Fellow (Jpn Soc Gastroenterologocal Endosc)
白石　壮宏 (Shiraishi Takehiro)	Instructor		General Surgery(Colorectal Surgery)	Board Certified Surgeon(Jpn Surg Assoc, Jpn Soc Gastroenterol Surg) Endoscopic surgical skill qualification system: qualified surgeon (Jpn Soc Enodsc Surg)
千代延　記道 (Chiyonobu Norimichi)	Instructor		Department of General Surgery(Heapato-Pancreato-Biliary Surgery)	Board Certified Surgeon(Jpn Surg Assoc, Jpn Soc Gastroenterol Surg) Board Certified Fellow (Jpn Soc Gastroenterologocal Endosc)
齋藤　稔史 (Saitou Toshifumi)	Instructor		General Surgery(Esophagp-Gastric Surgery) Endoscopic Surgery	Board Certified Surgeon(Jpn Surg Assoc, Jpn Soc Gastroenterol Surg) Board Certified Fellow (Jpn Soc Gastroenterologocal Endosc)
石川　博康 (Ishikawa Hiroyasu)	Instructor		Department of General Surgery	Board Certified Surgeon (Jpn Surg Assoc)
杉野　葵 (Sugino Aoi)	Instructor		Department of General Surgery	Board Certified Surgeon (Jpn Surg Assoc)
入江　直子 (Irie Naoko)	Instructor		Department of General Surgery
石井　挙大 (Ishii Takahiro)	Senior resident		Department of General Surgery
鈴木　佳那子 (Suzuki Kananko)	Senior resident		Department of General Surgery
石山　愛 (Ishiyama Ai)	Senior resident		Department of General Surgery
鈴木　興秀 (Suzuki Okihide)	Associate Professor Lecturer ゲノム診療科兼担		General Surgery Hereditary cancer/Genetic disorders Cancer precision medicine	Board Certified Surgeon (Jpn Surg Assoc,)
母里　淑子 (Mori Yoshiko)	Associate Professor Lecturer ゲノム診療科兼担		General Surgery Hereditary colorectal cancer/Cancer precision medicine Cancer Chemotherapy	Board Certified Surgeon(Jpn Surg Assoc, Jpn Soc Gastroenterol Surg)
辻　美隆 (Tsuji Yoshitaka)	Professor		Surgical Oncology	Board Certified Surgeon (Jpn Surg Assoc,Jpn Soc Gastroenterolo Surg)
石橋　敬一郎 (Ishibashi Keiichiro)	Associate Professor		General Surgery(Colorectal Surgery)	Board Certified Surgeon(Jpn Surg Assoc, Jpn Soc Gastroenterol Surg) Board Certified Fellow (Jpn Soc Gastroenterologocal Endosc)
岩間　毅夫 (Iwama　Takeo)	Part-time surgeon		General Surgery Hereditary cancer	Board Certified Surgeon (Jpn Surg Assoc,Jpn Soc Gastroenterolo Surg)
小倉　俊郎 (Ogura Toshiro)	Part-time surgeon		Department of General Surgery(Heapato-Pancreato-Biliary Surgery)	Board Certified Surgeon (Jpn Surg Assoc,Jpn Soc Gastroenterolo Surg)
天野　邦彦 (Amano Kunihiko)	Part-time surgeon		General Surgery(Colorectal Surgery)	Board Certified Surgeon (Jpn Surg Assoc,Jpn Soc Gastroenterolo Surg)
山本　梓 (Yamamoto　Azusa)	Part-time surgeon		Department of General Surgery	Board Certified Surgeon (Jpn Surg Assoc)
近谷　賢一 (Chikatani Kenichi)	Part-time surgeon		General Surgery(Colorectal Surgery)	Board Certified Surgeon (Jpn Surg Assoc, Jpn Soc Gastroenterol Surg)
牟田　優 (Muta Yuu)	Part-time surgeon		Department of General Surgery	Board Certified Surgeon (Jpn Surg Assoc)

Outpatient clinic

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