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首页> 外文期刊>Digestive endoscopy: official journal of the Japan Gastroenterological Endoscopy Society >Current status of training for endoscopic submucosal dissection for gastric epithelial neoplasm at Cancer Institute Hospital, Japanese Foundation for cancer research, a famous Japanese Hospital
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Current status of training for endoscopic submucosal dissection for gastric epithelial neoplasm at Cancer Institute Hospital, Japanese Foundation for cancer research, a famous Japanese Hospital

机译：日本著名癌症医院癌症研究基金会癌症研究所医院内镜检查胃上皮肿瘤黏膜下剥离的培训现状

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Aim: Endoscopic submucosal dissection (ESD) is relatively difficult compared with endoscopic mucosal resection (EMR), thus, proper training is essential for the safe performance of the procedure. The aim of this study is to clarify the current status of training for ESD for gastric epithelial neoplasm by following the performance of 13 preceptees. Methods: We performed ESD for 1520 lesions between March 2005 and April 2011 and conducted ESD training of 13 preceptees who were supervised by experts. We classified the samples into four groups according to the number of ESD performed by the preceptees to chart their progress by comparing the procedural outcomes. Group A included cases 1-40 performed by all 13 preceptees, group B consisted of cases 41-80 performed by 10 of the preceptees and group C included cases 81 onwards executed by five of the preceptees. Group D comprised the cases that were performed by experts during the same period as group C. Results: The procedural outcomes of group A were similar to those of group B with regard to operation time, complete en bloc resection and complications. However, the results of group B included significantly more lesions of the middle or upper third of the stomach, resected specimen and lesions were larger in diameter, lesions with positive ulcer finding were more frequent and a higher frequency of lesions were of expanded, non-indication type. Group B outcomes were similar to those of group C but differed in location of lesions and specimen size. Group C outcomes were similar to group D's in all parameters. Conclusion: Preceptees were able to safely perform ESD for gastric epithelium neoplasms under appropriate supervision by expert endoscopists. The number of cases in which preceptees successfully extracted guideline-indication lesions and expanded-indication lesions by ESD were approximately 40 and 80 cases, respectively. The procedural outcomes of ESD performed by preceptees who had experience in over 80 cases were similar to those by expert endoscopists. Thus, these findings show that the minimal amount of training for achieving preceptorship of ESD is performance of at least 80 of the procedures.
机译：目的：与内镜黏膜切除术（EMR）相比，内镜黏膜下剥离术（ESD）相对困难，因此，适当的培训对于手术的安全进行至关重要。这项研究的目的是通过遵循13个处方的表现来阐明胃上皮肿瘤ESD培训的现状。方法：我们在2005年3月至2011年4月之间对1520个病灶进行了ESD培训，并对13名受专家监督的处方进行了ESD培训。我们根据受训者执行的ESD数量将样本分为四组，以通过比较程序结果来绘制进度。 A组包括所有13个主持人执行的案例1-40，B组包括10个主持人执行的案例41-80，C组包括五个主持人开始执行的81个案例。 D组包括与C组同期由专家进行的病例。结果：就手术时间，完整切除和并发症而言，A组的手术结果与B组相似。但是，B组的结果包括胃中部或上三分之一的病变明显多，切除的标本和病变的直径更大，溃疡阳性的病变的发生频率更高，并且病变的发生频率更高，非指示类型。 B组结局与C组相似，但病变位置和标本大小不同。 C组结果在所有参数上均与D组相似。结论：在专业内镜医师的适当监督下，处方者能够安全地对胃上皮肿瘤进行ESD。处方者通过ESD成功地提取了指南指征病变和扩展指征病变的病例分别约为40例和80例。有80多个案例的受训者执行ESD的程序结果与专家内镜医师的结果相似。因此，这些发现表明，为实现ESD的感受力而进行的最少培训是至少执行80个程序。

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