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Digestive Disease Center,
Showa University Northern Yokohama Hospital

Conditions Treated
Colorectal Cancer (Includes Clinical Examination).

Treatment Methods (Endoscopic Treatments for Colorectal Cancer)

Colorectal cancer can be classified into 3 types: (1) the protruded type, in which the polyp that grows on the membrane (mucosa) enlarges and develops into cancer; (2) the pit-pattern (depressed) type, in which gastrointestinal mucosa caves in like a pit without forming a polyp; and (3) the lateral-spreading-tumor (LST) type, in which the cancer spreads sideways. While the polyp later becomes cancerous in only one area, the pit-pattern type is a malignant tumor from the start and progresses quickly. The LST type, like the pit-pattern type, is not easily detectable, and is difficult to treat.

If colorectal cancer is detected and treated at an early stage, however, treatability is high. Colorectal endoscopy is an excellent technique for early detection and treatment. The current magnifying endoscope with zoom apparatus (endocytoscopy), used worldwide, was co-developed by Dr. Shinei Kudo and a Japanese industrial firm. It operates at a magnification of 100x. This technological innovation enables a highly experienced, skilled specialist to detect not only polyps but also pit-pattern colorectal cancer, which can be highly malignant, in its early stages. We can also provide a detailed cancer diagnosis using endoscopy, and accurately assess the degrees of progression and malignancy. We select an appropriate treatment for each patient based on endoscopy results.

For early-stage cancer detected by gastrointestinal endoscopy (Stage 0-1). the gastrointestinal endoscope is used for therapy. For treatment of the protruded type, a snare is placed at the base of the polyp, and electrical current is passed through the snare to burn the tissue and excise the polyp. This is called polypectomy. For treatment of the pit-pattern and LST types, saline is injected underneath the mucosa to elevate and excise the lesion, then endoscopic mucosal resection (EMR) is performed. For larger cancers that cannot be excised by the EMR technique, the endoscopic submucosal dissection (ESD) technique is used. After injecting saline to elevate the lesion, a diathermic knife mounted on the tip of the endoscope is used to peel off the cancerous tissue. This relatively advanced method was developed in Japan and is only available at a limited number of medical facilities. The advantage of these techniques is that since cancerous tissue is removed under gastrointestinal endoscopy, the procedure is minimally invasive and therefore less stressful, both physically and emotionally, on the patient.

Features of Our Center

Specialists in gastrointestinal endoscopic diagnosis, pathological assessment, gastrointestinal endoscopic therapy, laparoscopic therapy and surgery work together as a team, and internal medicine physicians and surgeons collaborate during the process from diagnosis to treatment. Not only have we accepted numerous patients from overseas, but we have also added an international training center for endoscopy. We educate many young physicians from abroad who are dedicated to learning state-of-the-art medicine at our center.

Our director, Dr. Shinei Kudo, is a world-renowned authority in colorectal endoscopy, and he is best known for discovering pit-pattern gastrointestinal cancer. Regarded as unrivalled in precision and speed, he has performed over 200,000 gastrointestinal endoscopic examinations and is highly praised as one of Japan’s “Super Doctors.” He is known to perform EMR and ESD in a short period of time based on accurate endoscopic diagnostics. Consequently, patients experience less physical and emotional stress, and the recovery rate is high.

Number of ESD, EMR Performed for Upper Gastrointestinal Tract

Number of ESD, EMR Performed for Upper Gastrointestinal Tract

A Message to International Patients from Dr. Shinei Kudo, Our Center Director

Endoscopy, both an examination and therapeutic method, was first developed in Japan, and the technology has since been refined and improved. I believe it is my mission to serve colorectal cancer patients from all over the world by offering early detection, diagnosis, and therapy. Our center is internationally renowned for endoscopic diagnosis of digestive diseases, and we can treat you immediately after diagnosis. If you are over 40 and have a family history of colorectal cancer, I strongly recommend that you receive an assessment. We make risk assessments based on the epidemiological data from your home country, and have treated many international patients from Europe and Asia. Our staff members are specially trained to serve you, and it is our sincere hope that you feel comfortable while receiving treatment at our center.

PROFILE

Dr. Shinei Kudo
Dr. Shinei Kudo

Dr. Shinei Kudo is Director of the Digestive Disease Center at Showa University Northern Yokohama Hospital and vice director of this hospital.
In 1973, he graduated from the Faculty of Medicine at Niigata University and joined their department of surgery.
In 1985 he was assigned to the department of surgery at Akita Red Cross Hospital, and he was the first to report the discovery of pit-pattern colorectal cancer.
Based on a large number of case studies that he has conducted, Dr. Kudo has disproved the established theory that “colorectal cancer always begins with a polyp.” Since 2001, he has served as Professor at Showa University School of Medicine.
He has performed over 200,000 colonoscopies and has traveled around the world to give lectures, offer technical guidance, and perform treatment.

  • Wada Y, et al. Diagnostic accuracy of pit pattern and vascular patterns analyses in colorectal lesions. Dig Endosc. 2010; 22; 192-9.
  • Wada Y, et al. Diagnosis of colorectal lesions with the magnifying narrow-band imaging system. Gastroitest Endosc. 2009; 70; 522-31. ・Yamamoto S, et al. Japan Society of Laparoscopic Colorectal Surgery. Impact of conversion on surgical outcomes after laparoscopic operation for rectal carcinoma: a retrospective study of 1,073 patients. J Am Coll Surg. 2009; 208: 383-9.

Overview of the Treatment Schedule (Model Case)

For an examination, it takes about one month from the time the appointment is made to the time the first examination is given. If you are already suspected of having symptoms of colorectal cancer and need immediate attention, an evaluation will take place on an individual basis.

Overview of the Treatment Schedule

Photos

External View of Our Hospital High-Magnification Endoscope Developed by Dr. Kudo Dr. Kudo Performing a Colonoscopy
External View of Our Hospital
The special feature of our clinical system is that we use the “center method.” in which physicians of internal medicine and oncology surgeons work together as a team and make diagnoses using state-of-the-art medical technology in their specialized fields. The Digestive Disease Center is located on the 2nd floor (Endoscopy Center), 3rd floor (Operating Rooms), and the 7th floor (Patient Wards).
High-Magnification Endoscope Developed
by Dr. Kudo
Dr. Kudo Performing a Colonoscopy
Established 2001
(Relocated to the new site at the end of 2010)
Clinical Departments
Endoscopic Exam and Treatment of Digestive Diseases(Upper and Lower). Surgical Treatment, etc.
Payment Methods
Credit Card (VISA, MasterCard, JCB, American Express)

map

Address
35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama-shi, Kanagawa 224-8503
Take the Tokaido Shinkansen to Shin-Yokohama Station,
transfer to the Yokohama Municipal Subway,
and get off at Center-Minami Station
Approximately 15 minutes from
the Tomei Highway Yokohama Aoba Exit
60 minutes from
Tokyo International Airport (Haneda Airport) by car
URL
http://www10.showa-u.ac.jp/~hokubu/