{"id":856,"date":"2026-02-17T00:35:55","date_gmt":"2026-02-17T00:35:55","guid":{"rendered":"https:\/\/kishiwada.tokushukai.or.jp\/en\/?page_id=856"},"modified":"2026-03-13T07:46:22","modified_gmt":"2026-03-13T07:46:22","slug":"lower-gastrointestinal-surgery","status":"publish","type":"page","link":"https:\/\/kishiwada.tokushukai.or.jp\/en\/research\/publications\/lower-gastrointestinal-surgery\/","title":{"rendered":"Lower Gastrointestinal Surgery"},"content":{"rendered":"<p><!-- ============================================================\n     Katsuji Tokuhara, M.D., Ph.D. \u2014 Profile & Publications\n     URL: \/en\/departments\/lower-gi-surgery\/publications\/\n     Parent: \/en\/departments\/lower-gi-surgery\/\n     Focus Keyword: colorectal\n     ============================================================ --><\/p>\n<section class=\"op-section disease\">\n<div class=\"disease-kpi\">\n<div class=\"disease-kpi__item\">\n<div class=\"disease-kpi__label\">Specialty<\/div>\n<div class=\"disease-kpi__value\">Robot-assisted and laparoscopic colorectal surgery<\/div>\n<\/p><\/div>\n<div class=\"disease-kpi__item\">\n<div class=\"disease-kpi__label\">Experience<\/div>\n<div class=\"disease-kpi__value\">Approx. 1,400 operations as primary surgeon<\/div>\n<\/p><\/div>\n<div class=\"disease-kpi__item\">\n<div class=\"disease-kpi__label\">Appointed<\/div>\n<div class=\"disease-kpi__value\">Chief, Colorectal Surgery \u2014 April 2024<\/div>\n<\/p><\/div>\n<\/p><\/div>\n<p class=\"disease-lead\">\n    Katsuji Tokuhara, M.D., Ph.D. is Chief of Colorectal Surgery and Director of the Regional Medical Cooperation Center at Kishiwada Tokushukai Hospital.<br \/>\n    He specialises in robot-assisted and laparoscopic surgery for colorectal cancer, pelvic functional surgery, and multimodal treatment for advanced disease.\n  <\/p>\n<div class=\"profile-header\">\n    <img decoding=\"async\" src=\"\/en\/wp-content\/uploads\/2026\/03\/SrTokuhara.jpg\"\n         alt=\"Katsuji Tokuhara M.D. Ph.D. \u2014 colorectal surgery Japan, Kishiwada Tokushukai Hospital\"\n         class=\"profile-photo\"><\/p>\n<div class=\"profile-title\">\n<h2>Katsuji Tokuhara, M.D., Ph.D.<\/h2>\n<p style=\"margin:0 0 0.15rem; font-size:0.85rem; color:#888;\">\u5fb3\u539f \u514b\u6cbb<\/p>\n<p class=\"small-muted\">Chief, Colorectal Surgery<br \/>\n      Director, Regional Medical Cooperation Center<br \/>\n      Kishiwada Tokushukai Hospital<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"disease-rows\">\n<p>    <!-- Clinical focus --><\/p>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Clinical focus<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p>Dr. Tokuhara trained at Kansai Medical University and its affiliated hospitals,<br \/>\n        where he served as Associate Professor and Director of the Robot-Assisted Surgery Centre.<br \/>\n        He joined Kishiwada Tokushukai Hospital in April 2024.<\/p>\n<ul>\n<li><strong>Robot-assisted colorectal surgery<\/strong> (da Vinci Xi) \u2014 sphincter-preserving rectal resection, lateral pelvic lymph node dissection<\/li>\n<li><strong>Laparoscopic colorectal surgery<\/strong> \u2014 colectomy, rectal resection, intracorporeal anastomosis<\/li>\n<li><strong>Pelvic functional surgery<\/strong> \u2014 fecal incontinence, rectal prolapse, sacral nerve stimulation<\/li>\n<li><strong>Multimodal treatment<\/strong> \u2014 neoadjuvant chemotherapy, conversion surgery for advanced colorectal cancer<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<p>    <!-- \u2550\u2550 PUBLICATIONS BY TOPIC \u2550\u2550 --><\/p>\n<p>    <!-- Topic 1 --><\/p>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Rectal cancer \u2014<br \/>sphincter preservation &amp; pelvic surgery<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p class=\"disease-muted\">For patients seeking to avoid a permanent colostomy, or facing surgery for low rectal cancer.<\/p>\n<ol class=\"pubs-list\">\n<li>\n            Tokuhara K, et al.<br \/>\n            <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37485633\/\" target=\"_blank\" rel=\"noopener\">Robot-assisted laparoscopic lateral pelvic node dissection in advanced low rectal cancer.<\/a><br \/>\n            <em>Colorectal Disease.<\/em> 2023; 25: 1933\u20131934.<br \/>\n            <span class=\"pubs-note\">Robot-assisted removal of pelvic lymph nodes in advanced low rectal cancer.<\/span>\n          <\/li>\n<li>\n            Tokuhara K, et al.<br \/>\n            Laparoscopic total pelvic exenteration for locally advanced low rectal cancer invading the prostate \u2014 a video vignette.<br \/>\n            <em>Colorectal Disease.<\/em> 2022; 24: 799\u2013800.<br \/>\n            <span class=\"pubs-note\">Minimally invasive surgery for rectal cancer invading the prostate.<\/span>\n          <\/li>\n<li>\n            Tokuhara K, et al.<br \/>\n            <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32246236\/\" target=\"_blank\" rel=\"noopener\">Short-term outcomes of laparoscopic lateral pelvic node dissection for advanced lower rectal cancer.<\/a><br \/>\n            <em>Surgical Endoscopy.<\/em> 2021; 35: 1572\u20131578.<br \/>\n            <span class=\"pubs-note\">Outcomes data for laparoscopic lateral pelvic dissection in low rectal cancer.<\/span>\n          <\/li>\n<li>\n            Tokuhara K, et al.<br \/>\n            <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34390163\/\" target=\"_blank\" rel=\"noopener\">Laparoscopic prophylactic lateral pelvic lymph node dissection in advanced low rectal cancer \u2014 a video vignette.<\/a><br \/>\n            <em>Colorectal Disease.<\/em> 2021.<br \/>\n            <span class=\"pubs-note\">Preventive lymph node dissection via laparoscopy for advanced low rectal cancer.<\/span>\n          <\/li>\n<\/ol><\/div>\n<\/p><\/div>\n<p>    <!-- Topic 2 --><\/p>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Rectal cancer \u2014<br \/>chemotherapy before surgery<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p class=\"disease-muted\">For patients with advanced rectal cancer where shrinking the tumour first may improve outcomes or make surgery possible.<\/p>\n<ol class=\"pubs-list\">\n<li>\n            Tokuhara K, et al.<br \/>\n            <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35128134\/\" target=\"_blank\" rel=\"noopener\">Feasibility of neoadjuvant chemotherapy without radiotherapy for advanced rectal cancer.<\/a><br \/>\n            <em>Journal of the Anus Rectum and Colon.<\/em> 2022; 6: 24\u201331.<br \/>\n            <span class=\"pubs-note\">Pre-operative chemotherapy \u2014 without radiotherapy \u2014 for advanced rectal cancer.<\/span>\n          <\/li>\n<li>\n            Tokuhara K, et al.<br \/>\n            Feasibility of neoadjuvant chemotherapy without radiotherapy for advanced rectal cancer.<br \/>\n            <em>Indian Journal of Surgery.<\/em> 2021; 83: 1178\u20131184.<br \/>\n            <span class=\"pubs-note\">Further outcomes data on pre-operative chemotherapy for advanced rectal cancer.<\/span>\n          <\/li>\n<\/ol><\/div>\n<\/p><\/div>\n<p>    <!-- Topic 3 --><\/p>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Minimally invasive colorectal surgery \u2014<br \/>technique &amp; outcomes<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p class=\"disease-muted\">For patients considering laparoscopic or robot-assisted surgery for colon or rectal cancer.<\/p>\n<ol class=\"pubs-list\">\n<li>\n            Tokuhara K, et al.<br \/>\n            <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35426483\/\" target=\"_blank\" rel=\"noopener\">Intracorporeal anastomosis in laparoscopic right hemicolectomy (overlap method) \u2014 a video vignette.<\/a><br \/>\n            <em>Colorectal Disease.<\/em> 2022; 24: 1096.<br \/>\n            <span class=\"pubs-note\">Fully minimally invasive technique for right-sided colon cancer surgery.<\/span>\n          <\/li>\n<li>\n            Tokuhara K, et al.<br \/>\n            Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly.<br \/>\n            <em>International Journal of Surgery.<\/em> 2016; 27: 66\u201371.<br \/>\n            <span class=\"pubs-note\">Safety and outcomes of laparoscopic colorectal surgery in older patients.<\/span>\n          <\/li>\n<li>\n            Tokuhara K, et al.<br \/>\n            Efficacy and safety of thromboembolism prophylaxis with fondaparinux in Japanese colorectal cancer patients undergoing laparoscopic surgery.<br \/>\n            <em>International Journal of Surgery.<\/em> 2017; 42: 203\u2013208.<br \/>\n            <span class=\"pubs-note\">Perioperative safety in laparoscopic colorectal surgery.<\/span>\n          <\/li>\n<\/ol><\/div>\n<\/p><\/div>\n<p>    <!-- Topic 4 --><\/p>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Fecal incontinence &amp;<br \/>pelvic floor dysfunction<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p class=\"disease-muted\">For patients experiencing fecal incontinence or pelvic floor problems \u2014 including those occurring after rectal cancer treatment.<\/p>\n<ol class=\"pubs-list\">\n<li>\n            Tokuhara K, et al.<br \/>\n            Outcomes of neoadjuvant chemoradiotherapy in Japanese locally advanced rectal carcinoma patients.<br \/>\n            <em>World Journal of Surgical Oncology.<\/em> 2016; 14: 136.<br \/>\n            <span class=\"pubs-note\">Functional outcomes \u2014 including bowel function \u2014 after treatment for advanced rectal cancer.<\/span>\n          <\/li>\n<\/ol>\n<p class=\"disease-muted\" style=\"margin-top:12px;\">Further publications on sacral nerve stimulation and pelvic functional surgery are available in the full list below.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<p>    <!-- Full list accordion --><\/p>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Full publication list<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<details class=\"pubs-accordion\">\n<summary>View all publications \uff0b<\/summary>\n<div class=\"pubs-all\">\n<h4>Original articles (English)<\/h4>\n<ol>\n<li>Tokuhara K, et al. Robot-assisted laparoscopic lateral pelvic node dissection in advanced low rectal cancer. <em>Colorectal Disease.<\/em> 2023; 25: 1933\u20131934. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37485633\/\" target=\"_blank\" rel=\"noopener\">PubMed<\/a><\/li>\n<li>Tokuhara K, et al. Intracorporeal anastomosis in laparoscopic right hemicolectomy (overlap method). <em>Colorectal Disease.<\/em> 2022; 24: 1096. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35426483\/\" target=\"_blank\" rel=\"noopener\">PubMed<\/a><\/li>\n<li>Tokuhara K, et al. Laparoscopic total pelvic exenteration for locally advanced low rectal cancer invading the prostate. <em>Colorectal Disease.<\/em> 2022; 24: 799\u2013800.<\/li>\n<li>Tokuhara K, et al. Feasibility of neoadjuvant chemotherapy without radiotherapy for advanced rectal cancer. <em>Journal of the Anus Rectum and Colon.<\/em> 2022; 6: 24\u201331. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35128134\/\" target=\"_blank\" rel=\"noopener\">PubMed<\/a><\/li>\n<li>Tokuhara K, et al. Feasibility of neoadjuvant chemotherapy without radiotherapy for advanced rectal cancer. <em>Indian Journal of Surgery.<\/em> 2021; 83: 1178\u20131184.<\/li>\n<li>Tokuhara K, et al. Laparoscopic prophylactic lateral pelvic lymph node dissection in advanced low rectal cancer. <em>Colorectal Disease.<\/em> 2021. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34390163\/\" target=\"_blank\" rel=\"noopener\">PubMed<\/a><\/li>\n<li>Tokuhara K, et al. Short-term outcomes of laparoscopic lateral pelvic node dissection for advanced lower rectal cancer. <em>Surgical Endoscopy.<\/em> 2021; 35: 1572\u20131578. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32246236\/\" target=\"_blank\" rel=\"noopener\">PubMed<\/a><\/li>\n<li>Tokuhara K, et al. Efficacy and safety of thromboembolism prophylaxis with fondaparinux in Japanese colorectal cancer patients undergoing laparoscopic surgery. <em>International Journal of Surgery.<\/em> 2017; 42: 203\u2013208.<\/li>\n<li>Tokuhara K, et al. Outcomes of neoadjuvant chemoradiotherapy in Japanese locally advanced rectal carcinoma patients. <em>World Journal of Surgical Oncology.<\/em> 2016; 14: 136.<\/li>\n<li>Tokuhara K, et al. Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly. <em>International Journal of Surgery.<\/em> 2016; 27: 66\u201371.<\/li>\n<li>Tokuhara K, et al. Fluvastatin inhibits the induction of inducible nitric oxide synthase, an inflammatory biomarker, in hepatocytes. <em>Hepatology Research.<\/em> 2013; 7: 775\u2013784.<\/li>\n<li>Tokuhara K, et al. Rebamipide, anti-gastric ulcer drug, up-regulates the induction of iNOS in proinflammatory cytokine-stimulated hepatocytes. <em>Nitric Oxide.<\/em> 2008; 18: 28\u201336.<\/li>\n<\/ol>\n<h4>Case reports (English)<\/h4>\n<ol>\n<li>Obana T, Tokuhara K, et al. A case of diffusely infiltrating colorectal cancer with distinctive endoscopic and histologic findings. <em>iGIE.<\/em> 2023; 1: 22\u201323.<\/li>\n<li>Tokuhara K, et al. Peritoneal dissemination of ascending colon cancer demonstrating relapse-free survival for 40 months with panitumumab monotherapy. <em>International Journal of Surgery Case Reports.<\/em> 2019; 59: 41\u201345.<\/li>\n<li>Tokuhara K, et al. A first reported case of metastatic anorectal amelanotic melanoma with marked response to anti-PD-1 antibody nivolumab. <em>International Journal of Surgery Case Reports.<\/em> 2017; 31: 188\u2013192.<\/li>\n<li>Nakatani K, Tokuhara K, et al. Laparoscopic surgery for colon cancer with intestinal malrotation in adults. <em>International Journal of Surgery Case Reports.<\/em> 2017; 39: 86\u201390.<\/li>\n<li>Tokuhara K, et al. Laparoscopic reduced port surgery for schwannoma of the sigmoid colon. <em>Asian Journal of Endoscopic Surgery.<\/em> 2014; 7: 260\u2013262.<\/li>\n<li>Tokuhara K, et al. Primary squamous cell carcinoma in the gastric remnant. <em>Surgery Today.<\/em> 2012; 42: 666\u2013669.<\/li>\n<\/ol>\n<h4>International presentations (first author)<\/h4>\n<ol>\n<li>Outcomes of laparoscopic lateral pelvic lymph node dissection in locally advanced rectal cancer. 75th General Meeting, Japan Society of Gastroenterological Surgery. 2020.<\/li>\n<li>Short and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly. 3rd International Conference of Federation of Asian Clinical Oncology. 2019.<\/li>\n<li>Liver protective effect of pyroGlu-Leu in proinflammatory cytokine-stimulated hepatocytes. 35th ESPEN Congress. 2013.<\/li>\n<li>Fluvastatin inhibits the induction of iNOS, inflammatory biomarker, in hepatocytes. 34th ESPEN Congress. 2012.<\/li>\n<li>Anti-gastric ulcer drug upregulates the induction of iNOS in IL-1\u03b2-stimulated hepatocytes. Clinical Nutrition Week, ASPEN. 2007.<\/li>\n<\/ol><\/div>\n<\/details><\/div>\n<\/p><\/div>\n<p>    <!-- Certifications --><\/p>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Certifications<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<ul>\n<li>M.D., Ph.D.<\/li>\n<li>Board-certified surgeon \u2014 Japan Surgical Society<\/li>\n<li>Board-certified surgeon \u2014 Japanese Society of Gastroenterological Surgery<\/li>\n<li>Board-certified colorectal surgeon \u2014 Japan Society of Coloproctology<\/li>\n<li>Technical certification in endoscopic surgery \u2014 Japan Society for Endoscopic Surgery<\/li>\n<li>da Vinci console surgeon certificate<\/li>\n<li>Robotic surgery proctor \u2014 Japan Society for Endoscopic Surgery<\/li>\n<li>Cancer treatment physician \u2014 Japanese Society for Cancer Treatment<\/li>\n<li>Designated physician \u2014 Osaka Prefecture intractable disease programme<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<p>    <!-- Back --><\/p>\n<div class=\"disease-row\">\n<div class=\"disease-row__h\">\n<h2>Department<\/h2>\n<\/p><\/div>\n<div class=\"disease-row__b\">\n<p><a href=\"\/en\/departments\/lower-gi-surgery\/\">\u2190 Colorectal Surgery (Lower GI Surgery)<\/a><\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n<p><script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@type\": \"Person\",\n  \"@id\": \"https:\/\/kishiwada.tokushukai.or.jp\/en\/departments\/lower-gi-surgery\/publications\/#person\",\n  \"name\": \"Katsuji Tokuhara\",\n  \"honorificSuffix\": \"M.D., Ph.D.\",\n  \"jobTitle\": \"Chief, Colorectal Surgery\",\n  \"worksFor\": {\n    \"@type\": \"Hospital\",\n    \"name\": \"Kishiwada Tokushukai Hospital\",\n    \"url\": \"https:\/\/kishiwada.tokushukai.or.jp\/en\/\"\n  },\n  \"knowsAbout\": [\n    \"Colorectal surgery\", \"Rectal cancer\", \"da Vinci robotic surgery\",\n    \"Laparoscopic colorectal surgery\", \"Pelvic functional surgery\",\n    \"Lateral pelvic lymph node dissection\", \"Fecal incontinence\",\n    \"Sacral nerve stimulation\", \"Neoadjuvant chemotherapy\"\n  ],\n  \"hasCredential\": [\n    \"Board-certified surgeon, Japan Surgical Society\",\n    \"Technical certification, Japan Society for Endoscopic Surgery\",\n    \"da Vinci console surgeon certificate\",\n    \"Robotic surgery proctor, Japan Society for Endoscopic Surgery\"\n  ]\n}\n<\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Specialty Robot-assisted and laparoscopic colorectal surgery Experience Approx. 1,400 operations as primary surgeon Appointed Chief, Colorectal Surgery \u2014 April 2024 Katsuji Tokuhara, M.D., Ph.D. is Chief of Colorectal Surgery and Director of the Regional Medical Cooperation Center at Kishiwada Tokushukai Hospital. He specialises in robot-assisted and laparoscopic surgery for colorectal cancer, pelvic functional surgery, and [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":942,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-856","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages\/856","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/comments?post=856"}],"version-history":[{"count":11,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages\/856\/revisions"}],"predecessor-version":[{"id":1199,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages\/856\/revisions\/1199"}],"up":[{"embeddable":true,"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/pages\/942"}],"wp:attachment":[{"href":"https:\/\/kishiwada.tokushukai.or.jp\/en\/wp-json\/wp\/v2\/media?parent=856"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}