胃癌是东亚地区发病率较高的常见恶性肿瘤。胃切除范围从内镜切除到开腹全胃切除术。然而，缺乏全国范围的数据。这项观察性研究分析了可公开访问的国家健康保险索赔和特定健康检查数据库的数据，其中包括日本大多数国民健康保险索赔数据。调查了2014年至2021年胃恶性肿瘤切除类型的变化趋势、患者的年龄和性别分布以及地区差异。2015年每年的切除数量最高（109,000例），2020年最低（90,000例）。 2019冠状病毒病大流行。内镜切除的比例从2014年的47%增加到2021年的57%，而全胃切除术的比例从17%下降到10%。 2021年，接受切除术的患者中有70%是男性。那一年，接受任何类型胃切除术的所有患者中，83.8% 的患者和接受内镜粘膜下剥离术的患者中，87.1% 的年龄≥65 岁。每百万人口胃切除术的年发生率最高的是鸟取县（n = 1236），最低的是冲绳县（n = 251）。宫城县内镜切除比例最高（66%），爱知县最低（45%）；青森县开腹手术比例最高（36%），和歌山最低（5%）。胃恶性肿瘤的内镜治疗日益普及粘膜下剥离术而不是开放性全胃切除术。然而，切除类型仍存在地区差异。需要标准化治疗和更均匀的专家分布。© 2024。作者。

Gastric cancer is a common malignancy with a high incidence in East Asia. Gastric resection ranges from endoscopic resection to open total gastrectomy. However, nationwide data are lacking.This observational study analyzed data from the publicly accessible National Database of Health Insurance Claims and Specific Health Checkups, which includes most national health insurance claims data in Japan. Trends in the types of resection performed for malignant gastric tumors between 2014 and 2021, patients' age and sex distributions, and regional disparities were investigated.The annual number of resections was highest in 2015 (109,000) and lowest in 2020 (90,000) after the COVID-19 pandemic. The proportion of endoscopic resections increased from 47% in 2014 to 57% in 2021 while that of total gastrectomies decreased from 17 to 10%. In 2021, 70% of patients who underwent resection were men. That year, 83.8% of all patients who underwent any type of gastric resection and 87.1% of those who underwent endoscopic submucosal dissection were aged ≥ 65 years. The annual incidence of gastric resection per million population was highest in Tottori (n = 1236) and lowest in Okinawa (n = 251). The proportion of endoscopic resections was highest in Miyagi (66%) and lowest in Aichi (45%) and that of open surgery was highest in Aomori (36%) and lowest in Wakayama (5%).Gastric malignancy is increasingly treated by endoscopic submucosal dissection rather than open total gastrectomy. However, regional disparities remain in resection type. Standardization of treatment and a more even distribution of specialists are needed.© 2024. The Author(s).