[Paths of innovative surgery in gastrointestinal cancer in our department].

Our Department of Surgery was founded in 1982 by Prof. Inoko who performed reportedly the first gastrectomy for gastric cancer in Japan. Prof. Mine developed the auto-suture device which was world first one in 1958. We have carried out novel therapeutic methods for metastases and invasions in gastrointestinal cancer. For the management of lymph node metastasis, we developed emulsion and activated carbon particles containing anticancer agents which were selectively delivered to lymph nodes. Activated carbon particles visualized the regional lymph nodes as blackened nodes which can be easily dissected at time of surgery. Mitomycin C bound to carbon particles was effective for prophylaxis and treatment of peritoneal metastasis in prospective randomized control study. For prevention of postoperative local recurrence of rectal cancer, we developed preoperative 3 combined treatments with radiation, hyperthermia and 5-Fluorouracil suppository therapy. This 3 combined treatments resulted in improvement of survival and decreasing the local recurrence. For the new challenge to metastasis we have tried to apply the monoclonal antibody drug conjugate, angiogenesis inhibitor and immuno-guided surgery.