J.Jpn. Surg. Soc.. 127(4): 386-390, 2026

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Feature topic

CURRENT STATUS AND CHALLENGES OF EMERGENCY GENERAL SURGERY IN JAPAN

Emergency general surgery (EGS) constitutes a core pillar of acute care surgery (ACS), a concept originally proposed in the USA. In Japan, the incidence of EGS diseases is rising due to the rapidly aging population. Compared with elective surgery, EGS is characterized by higher mortality rates and greater consumption of medical resources, presenting significant clinical challenges. As surgical subspecialization continues to advance, the role of acute care surgeons, specialists capable of providing cross-organ emergency interventions, becomes increasingly vital. Their expertise contributes not only to improving the quality of clinical care but also to preserving “surgical generalship” by educating younger surgeons in open surgical techniques. Furthermore, implementing ACS models facilitates a “task-shifting” approach, which is essential for promoting work-style reforms among surgeons. Currently, issues such as outcome evaluation based on objective data, standardization of treatment, and the establishment of clear educational roadmaps for future surgeons remain insufficiently addressed and represent critical future tasks. Establishing EGS as a distinct specialty and nurturing the next generation of surgeons are indispensable to building a sustainable, high-quality surgical healthcare system.

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