Analysis of endoscopic submucosal dissection training system construction

中华消化内镜杂志 Pub Date : 2020-01-20 DOI:10.3760/CMA.J.ISSN.1007-5232.2020.01.005

Min Chen, Yu-ling Yao, Xiaoqi Zhang, Lei Wang, Ying Lyu, X. Zou, T. Ling

{"title":"Analysis of endoscopic submucosal dissection training system construction","authors":"Min Chen, Yu-ling Yao, Xiaoqi Zhang, Lei Wang, Ying Lyu, X. Zou, T. Ling","doi":"10.3760/CMA.J.ISSN.1007-5232.2020.01.005","DOIUrl":null,"url":null,"abstract":"Objective \nTo investigate the prerequisites for endoscopists, who were chosen to receive endoscopic submucosal dissection (ESD) training. \n \n \nMethods \nA total of 41 trainees, who attended ESD training in the endoscopic center of Nanjing Drum Tower Hospital from January 2017 to June 2018 were enrolled in the study. The general information of the subjects were collected, including name, age, gender, the number of gastroscopy and colonoscopy independently performed before training, the independent usage of narrow band image (NBI), magnifying endoscopy (ME), endoscopic mucosal resection (EMR), ESD, endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP) before training. And then every trainee independently finished four in vitro experiments of pig esophagus ESD. The specimen area and operating time were recorded, and the operating speed was calculated. Linear regression analysis was used to analyze the affecting factors of operating speed of ESD. \n \n \nResults \nAmong the 41 trainees, 26 were male and 15 were female, with age of 36.07±4.44 years. The specimen area, operating time and operating speed of pig esophagus ESD was 4.67±1.61 cm2, 24.54±5.97 min, and 0.19±0.05 cm2/min, respectively. Univariate linear regression analysis showed that the number of gastroscopy (n>5 000, P=0.001 8) and colonoscopy (n>3 000, P=0.000 1), the detect number of early cancer in upper digestive tract (n>30, P=0.000 3) and lower digestive tract (n>10, P=0.019 7), and the usage of ME (P=0.047 8), EMR (P=0.019 6) and ESD (P=0.000 3) before training were statistically correlated with the operating speed of ESD. Carrying out NBI (P=0.532 9), ERCP (P=0.500 7) and EUS (P=0.766 8) before training were not statistically correlated with the operating speed of ESD. The operating speed of ESD was negatively correlated with the perforation rate of ESD (P<0.000 1). According to multivariable linear regression model, the usage of EMR (P=0.029) and ESD (P=0.034) were statistically correlated with the operating speed of ESD. \n \n \nConclusion \nESD trainees, who have the number of gastroscopy more than 5 000, the number of colonoscopy more than 3 000, the detect number of early cancer more than 30 in upper digestive tract and 10 in lower digestive tract, and the usage of ME, EMR and ESD before training, can get a better training effect. The study provides a theoretical basis for selecting appropriate ESD trainees. \n \n \nKey words: \nAnimal models; In vitro; Endoscopic submucosal dissection; Operating training; Dissection time","PeriodicalId":10072,"journal":{"name":"中华消化内镜杂志","volume":"37 1","pages":"22-27"},"PeriodicalIF":0.0000,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华消化内镜杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2020.01.005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Objective To investigate the prerequisites for endoscopists, who were chosen to receive endoscopic submucosal dissection (ESD) training. Methods A total of 41 trainees, who attended ESD training in the endoscopic center of Nanjing Drum Tower Hospital from January 2017 to June 2018 were enrolled in the study. The general information of the subjects were collected, including name, age, gender, the number of gastroscopy and colonoscopy independently performed before training, the independent usage of narrow band image (NBI), magnifying endoscopy (ME), endoscopic mucosal resection (EMR), ESD, endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP) before training. And then every trainee independently finished four in vitro experiments of pig esophagus ESD. The specimen area and operating time were recorded, and the operating speed was calculated. Linear regression analysis was used to analyze the affecting factors of operating speed of ESD. Results Among the 41 trainees, 26 were male and 15 were female, with age of 36.07±4.44 years. The specimen area, operating time and operating speed of pig esophagus ESD was 4.67±1.61 cm2, 24.54±5.97 min, and 0.19±0.05 cm2/min, respectively. Univariate linear regression analysis showed that the number of gastroscopy (n>5 000, P=0.001 8) and colonoscopy (n>3 000, P=0.000 1), the detect number of early cancer in upper digestive tract (n>30, P=0.000 3) and lower digestive tract (n>10, P=0.019 7), and the usage of ME (P=0.047 8), EMR (P=0.019 6) and ESD (P=0.000 3) before training were statistically correlated with the operating speed of ESD. Carrying out NBI (P=0.532 9), ERCP (P=0.500 7) and EUS (P=0.766 8) before training were not statistically correlated with the operating speed of ESD. The operating speed of ESD was negatively correlated with the perforation rate of ESD (P<0.000 1). According to multivariable linear regression model, the usage of EMR (P=0.029) and ESD (P=0.034) were statistically correlated with the operating speed of ESD. Conclusion ESD trainees, who have the number of gastroscopy more than 5 000, the number of colonoscopy more than 3 000, the detect number of early cancer more than 30 in upper digestive tract and 10 in lower digestive tract, and the usage of ME, EMR and ESD before training, can get a better training effect. The study provides a theoretical basis for selecting appropriate ESD trainees. Key words: Animal models; In vitro; Endoscopic submucosal dissection; Operating training; Dissection time

查看原文本刊更多论文

内镜下黏膜下剥离训练系统构建分析

目的探讨内镜医师接受内镜黏膜下剥离术（ESD）培训的前提条件。方法对2017年1月至2018年6月在南京鼓楼医院内镜中心参加ESD培训的41名学员进行研究。收集受试者的一般信息，包括姓名、年龄、性别、训练前独立进行胃镜和结肠镜检查的次数、训练前窄带图像（NBI）、放大内镜（ME）、内镜黏膜切除术（EMR）、ESD、内镜超声（EUS）和内镜逆行胰胆管造影（ERCP）的独立使用情况。然后每个受试者分别完成了4个猪食管ESD的体外实验。记录试样面积和操作时间，并计算操作速度。采用线性回归分析法对ESD运行速度的影响因素进行了分析。结果41名学员中，男26名，女15名，年龄36.07±4.44岁。猪食管ESD的标本面积、操作时间和操作速度分别为4.67±1.61cm2、24.54±5.97min和0.19±0.05cm2/min。单因素线性回归分析显示，胃镜检查（n＞5 000，P＝0.001 8）和结肠镜检查（n＜3 000，P＜0.000 1），上消化道早期癌症检出数（n＞30，P＝0.000 3）和下消化道早期癌症检出数（n＞10，P＝0.019 7），训练前的EMR（P=0.019 6）和ESD（P=0.000 3）与ESD的操作速度有统计学相关性。训练前进行NBI（P=0.532 9）、ERCP（P=0.500 7）和EUS（P=0.766 8）与ESD的操作速度无统计学相关性。ESD的操作速度与ESD的穿孔率呈负相关（P＜0.0001）。根据多变量线性回归模型，EMR（P=0.029）和ESD（P=0.034）的使用与ESD的运行速度具有统计学相关性。结论ESD受训者胃镜检查次数在5000次以上，结肠镜检查次数在3000次以上，上消化道早期癌症检出次数在30次以上，下消化道早期检出次数在10次以上，训练前应用ME、EMR和ESD，可获得较好的训练效果。该研究为选择合适的ESD学员提供了理论依据。关键词：动物模型；体外；内镜黏膜下剥离术；操作培训；解剖时间

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

中华消化内镜杂志

CiteScore

0.10

自引率

0.00%

发文量

7555

期刊介绍： Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy. Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience. The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications. The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research. Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.