学习导航:第三空间内窥镜培训、技术和实用建议的综合培训

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
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引用次数: 0

摘要

第三空间内窥镜检查(TSE),包括ESD、POEM或STER,都是需要精确内窥镜控制和组织识别的高级手术。尽管 TSE 的应用越来越广泛,但目前还缺乏循证课程和标准化培训方案。本综述探讨了内镜医师执行 TSE 的培训方法、认知技能和技术熟练程度要求,重点是 POEM。一般来说,建议采用循序渐进的方法进行 TSE 培训似乎是明智之举,首先从体内外模型或 POEM 模拟器开始;机械和虚拟现实 (VR) 模拟器通常用于早期培训。建议进行涉及体外和活体动物模型的临床前培训,使学员为安全有效的手术做好准备。研究表明,培训的手术数量不尽相同,大约需要 20-40 个病例才能在并发症和速度方面达到第一个高峰。住院临床培训的时间长短取决于先前的经验。导师计划、研讨会和病例讨论可促进知识的动态传递。此外,不良事件处理也是任何 TSE 培训计划的一个重要方面。现有证据支持使用临床前模型,并强调了与我们所建议的阶梯式培训方法一致的 TSE 专业培训计划的重要性。本综述概述了开始 TSE 培训前所需理论知识和技术技能的实用建议,包括临床理解、诊断和结果评估、程序要求以及导师计划的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Navigating the learning landscape: Comprehensive training in third space endoscopy - training, techniques, and practical recommendations

Third space endoscopy (TSE), including ESD, POEM, or STER are advanced procedures requiring precise endoscopic control and tissue recognition. Despite its increasing adoption, evidence-based curricula, and standardized training protocols for TSE are lacking. This review explores training methods, cognitive skills, and technical proficiency requirements for endoscopists performing TSE, with a primary emphasis on POEM. Generally, it seems wise to recommend a step-up approach to TSE training, starting with ex-vivo models or POEM simulators; mechanical and virtual reality (VR) simulators are commonly used during early training. Preclinical training involving ex-vivo and live animal models is suggested to prepare trainees for safe and effective procedures. Studies suggest varying numbers of procedures for training, with approximately 20–40 cases needed before a first plateau is achieved in terms of complications and speed. The duration of on-patient clinical training varies depending on prior experience. Mentorship programs, workshops, and case discussions may facilitate dynamic knowledge transfer. In addition, adverse event management is a crucial aspect of any TSE training program. Existing evidence supports the use of preclinical models and emphasizes the importance of specialized training programs for TSE in alignment with our proposed step-up training approach. This review outlines practical recommendations for the theoretical knowledge and technical skills required before commencing TSE training, covering clinical understanding, diagnostic and outcome assessment, procedural requirements, and the role of mentorship programs.

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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
23
审稿时长
69 days
期刊介绍: Each topic-based issue of Best Practice & Research Clinical Gastroenterology will provide a comprehensive review of current clinical practice and thinking within the specialty of gastroenterology.
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