Always providing the best medical care to patients in Hokkaido.

The Hokkaido University Hospital Department of Thoracic Surgery has recently been established as an independent department. This independence has provided us the opportunity to establish our own traditions and chart our own path. I have been appointed as the first professor of this new Department, and I am humbled by the weight of that responsibility.

The number of lung cancer surgeries has increased with the times, having nearly tripled since I first joined our original department. Together with Hokkaido University Hospital and its 19 affiliates, nearly 2,700 surgeries are performed annually, of which more than 1,400 are lung cancer cases. My first and greatest responsibility, along with those of my colleagues, is to continue delivering the best, cutting-edge medical care to patients in Hokkaido. In addition, as a core hospital for cancer genomic medicine in Hokkaido, we intend to promote the practice of personalized medicine and the development of new treatment methods.

One of the immediate tasks given to our Department is the realization of lung transplantation in Hokkaido. Currently, there are 10 facilities certified for lung transplantation in Japan,but there is not even one in Hokkaido. The key to a successful lung transplant program is cooperation with related departments, and we will work closely with our colleagues to develop a comprehensive transplant team. Achieving this lofty goal will require a large number of passionate, young professionals. I hope that this bright future for our Department excites you as it does me ‒ and that many young people with the same aspirations will knock on the door of our department. We would be excited to have you join us in this journey.

Department of Thoracic Surgery, Hokkaido University Hospital
Professor and Chairman. Tatsuya Kato, MD, PhD

Due to the reorganization of the clinical departments at Hokkaido University Hospital, we have decided to separate from the Cardiovascular and Thoracic Surgery Department and start a new, independent Department of Thoracic Surgery.
Originally, "Thoracic Surgery" at Hokkaido University operated almost independently as a respiratory group since 1924 with the establishment of the Second Department of Surgery. At that time, the Department provided a wide range of surgical treatments for pulmonary tuberculosis. A later reorganization of the graduate school created the Department of Oncology Surgery, consisting of two pillars: Gastroenterological Surgery and Thoracic Surgery. The Thoracic Surgery group subsequently merged with Cardiovascular Surgery to form the “Department of Cardiovascular and Thoracic Surgery." This was in fact the first time “Thoracic Surgery” appeared in the name of a clinical department at Hokkaido University Hospital.

Lung cancer has been the leading cause of death in Japan since 1995, claiming the lives of ~53,000 men and ~22,000 women annually (Ministry of Health, Labor and Welfare. 2019). Hokkaido unfortunately suffers from a much higher mortality than the national average (age-adjusted mortality 18.1 per 100,000 patient-years versus 14.5 per 100,000 patient-years nationally, for those under 75). This is partially attributable to our high smoking rate, with 32% of men and 15% of women being smokers, in addition to low rates of routine health checks.
Encouraging a healthy lifestyle that modifies risk factors for lung cancer, and detecting cancer at an earlier stage, is the joint responsibility of both the public and private sector.

Hokkaido University Hospital was an early pioneer in Japan in minimally invasive thoracic surgery, known as thoracoscopic surgery or VATS. More recently, we have expanded our capabilities in minimally invasive surgery (MIS) to perform surgery using a single, small incision,
called uniportal VATS, and using robots (RATS). MIS has particular benefits for patients who are elderly or who are high-risk f or surgery.
However, while MIS is generally well-suited for those with earl y-stage lung cancer, we are also experienced in the management of advanced lung cancer, including complex surgical resections and integrated multidisciplinary/multimodality treatment.

The two pillars of our clinical practice and research are "Pursuing more effective surgery" and "Ensuring the safety and efficacy of surgical resection in combination with chemotherapy, radiotherapy, and immunotherapy for advanced lung cancer". Despite the growing number of malignant lung tumor surgeries at Hokkaido University Hospital, the high proportion of cases completed using MIS techniques is a feature of our Department of Thoracic Surgery. At Hokkaido University Hospital, the Department of Thoracic Surgery, Department of Respiratory Medicine, Department of Medical Oncology, and Department of Radiation Oncology work closely together through a multidisciplinary tumor board to provide cutting-edge, integrated diagnosis and treatment to every patient. To reduce mortality from lung cancer, multidisciplinary care also includes research cooperation with basic science laboratories and pathology departments. We expect this mutual development will only be further strengthened with the introduction of our new Department of Thoracic Surgery.