The department was established by the first professor Katsuhiko Sugahara in 1980. It showed significant advancement under the leadership of the second professor Yoshiro Matsumoto who took the position in 1992. The current professor Hideki Fujii came to the position in 2003. Since its establishment, the most emphasized goal is "to provide the best treatment for people who suffer". In order to reach the goal, we aim for the advancement of techniques as a clinician, research that can feed back to clinical activities, and education to nurture capable clinicians and researchers in the future. This is the unchanging philosophy of the department.

Education: Medical education is the most important assignment of all for a medical school. We believe that education should be provided throughout the undergraduate and postgraduate courses under the same principle. That is; we, as educators, are responsible for establishing “the best treatment method” at the present time and pass it on. We also should provide medical students and residents with a proper environment in which they become aware of the necessity to seek even better treatment by themselves. For undergraduate education, especially for the fifth-year students who begin clinical training for the first time, we try to enhance their motivation and interest for clinical work by employing a clinical clerkship system. For the sixth-year students, we go further and include a high level of surgical procedures which is necessary for a clinician in their elective clinical training course. For the education of medical students before beginning their clinical training, we closely cooperate with the Second Department of Surgery which advocates cardiovascular, thoracic, and pediatric surgery to make a curriculum with current and important themes. We are currently working on implementing educational reform with a view that tutorial educational is necessary for students to enhance their problem solving abilities.

For postgraduate education, an obligatory postgraduate clinical training program is employed. Although enforcement of this program is rather controversial, we think that it should be built on the top of a solid graduate education. On that presupposition, we try to manipulate the content of our clinical training in surgery so that it will help post-graduate students in choosing their future direction.
For residency after the post-graduate clinical training, we have prepared a curriculum of advanced clinical training to be qualified for becoming a Certified Surgeon, Certified Specialist Surgeon, and Certified Advising Surgeon in accordance with each society's qualifications.

Medical Practice: The First Department of Surgery of the University Hospital covers the area of general surgery, gastroenterological surgery (liver, biliary tract, pancreas, upper gastrointestinal (GI) tract including the esophagus and stomach, and lower GI tract such as the colon, rectum, and anus), endcrinological surgery that includes the area of the breast and thyroid glands. Our accomplishment in each area has exceeded prefectural and national levels. In the field of hepatic surgery, we established and employ the concept of "multicentric occurrence" to improve treatment results. For the treatment of carcinoma of the biliary tract, we perform corporative surgery with vascular surgeons (the Second Department of Surgery) conducting resection and reconstruction of the major vessles. In cases that were determined to be inoperative by other institutes, and we keep improving the outcome. For the treatment of pancreatic cancer, after establishing a safe and radical operative procedure, we combined various antitumor agents including gemzar and our own "intraoperative radiation" therapy. This has improved the outcomes of treatment of pancreatic cancer cases with a very poor prognosis. For the treatment of advanced esophageal cancer, which was believed to be unresectable, we try to improve the rate of successful resection by conducting the surgery after the tumor shrinking in response to radiation therapy. We also try to enhance the immunity of the patients, particularly where they experience massive surgical invasions throughout the perioperative period. For the treatment of stomach cancer, we conduct forward-looking treatment, using adoptive immunotherapy that introduces activated lymph cells to attack the tumor, or cancer vaccine therapy. For the treatment of the lower GI tract problems, we emphasize function preserving operations (function of urination and ejaculation) without sacrificing the radical nature of the surgery. We have prepared a regimen of many antitumor agents against advanced cancer, to increase the long-term survival rate. For the treatment of breast cancer, we have determined the poor prognosis factors based on our past research results. We select the best postoperative therapy for the patients accordingly focusing on antitumor agents in consideration of the patient's QOL. More recently, we have tended to choose antibody therapy in order to enhance the prognosis. Furthermore, we employed the concept of sentinel lymph node biopsy with which you can avoid excess dissection of the lymph node in order to develop a minimal operation for breast cancer and improve the patient's postoperative QOL. Although the certified specialists in each area in the department are in charge of these treatments, all our specialists, including the professor, are involved in everyday diagnostic and therapeutic efforts in close collaboration.

Research:Our basic attitude toward research activity is to start with the clinical level and also end with the clinical level. All of the favorable treatment outcomes described above, in fact, started from this research. First of all, the multicentric occurrence of the liver was discovered by genetic research. However, the favorable outcome is limited to HBV, and we still do not have a tool to tackle HCV infection, which is the most important hepatic cell-related target. We are currently working on the development of this tool. We also try to add hepatic sinusoidal function to a conventional artificial liver which is limited to hepatocyte only and develop a new type of artificial liver based on our long-standing research analyzing the function of hepatic sinusoid cells. We also conduct research on regulation of the sinusoidal function of the liver to protect the patient's liver during the perioperative period since we often face operating on livers in a pathologic condition.
In terms of immune therapy against malignant tumors, we not only do research on it but also apply it in a clinical setting. We are expecting this research and application to show great efficacy.

Additionally, regarding each organ, we conduct research on cancer-related genes to determine the cause and pathology of the disease, molecular biological research in on cell level, and research on the relationship between infection and failing organs.

These research themes have started and developed from faculty member's individual challenges. We believe it is ideal to integrate all of these research areas through the study process.

Meanwhile, the medical staff in charge of the relevant organ and the professor play a leading role in deciding on a course of treatment and clinical research to improve it.

Medical Staff

Other Research:
Research on the differentiation of hepatocellular carcinoma (Naohiro Hosomura)
Research on the heterogeneity of monocyte in stomach cancer (Yoshiki Mizukami)
Analyses of TGFβ signaling in the cancer of the pancreas（Hiromichi Kawaida）
Research on the sinusoidal function of the liver and hepatic regeneration（Hidetake Amemiya）
Investigation into the T-lymphocyte's cytokine-unresponsivity in stomach cancer（Hideo Omata）
Analyses of factors linked to the local recurrence of colon cancer（Yoshiyuki Mori）
Analyses on the expression EGFR and erbB2 in the cancer of digestive organs（Masayuki Inoue）
Research on the significance of the lymphocytic infiltration in stomach cancer（Satoshi Hyuga）
The relation between the development and the growth of hepatocellular carcinoma and hepatic sinusoid cells（Yoshihiko Kawaguchi）
Research on the hepatic sinusoidal function's involvement in the multiple organ failure (Masato Tsuchiya)
Research on the reinforcement of the dendritic cells in the immune therapy against stomach cancer (Kosaku Mimura）