食道内視鏡筋切除の熟練度:学習曲線のメタ解析
Yizhong Wu1, Alexander Grieme1, Manuel Garza2
1Department of Internal Medicine.
Journal of clinical gastroenterology
|September 2, 2025
まとめ
口腔内視鏡筋切除 (POEM) 訓練では20~40回の処置で熟練することが示されています. この学習段階の後,さらなる経験は手続のスピードを大幅に改善しません.
科学分野:
- 胃腸内科
- 外科 教育
- エンドスコピーの手順
背景:
- 口腔内視鏡筋切除 (POEM) の学習曲線を評価することは,外科研修において極めて重要です.
- 手続きの期間は,POEMのスキルの重要な指標です.
研究 の 目的:
- 口腔内視鏡筋切除 (POEM) 訓練の学習曲線を評価する.
- POEMの熟練度を達成するために必要な手順の数を決定します.
主な方法:
- PubMed,Embase,Cochrane,Web of Scienceの体系的な文献検索を行いました
- 学習段階に分割されたデータ: 0-20,20-40および40-60の累積的な手順.
- ANOVAと逆曲線回帰を含む統計分析により,熟練度が評価される.
主要な成果:
- 3197件のPOEM手順を対象とした11件の研究が分析された.
- 0~20のグループから20~40のグループ,そして40~60のグループに,平均的な処置時間は著しく減少した.
- 処置のスピードの熟達度は約33回の処置で,ピートアップ時間は約80分でした.
結論:
- 口腔内視鏡筋切除 (POEM) 学習者は20〜40の累積的な処置段階で処置速度を熟練します.
- 処置のスピードの有意な改善は,40-60処置段階を超えた経験では観察されなかった.
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