在内镜粘膜切除培训中选择病例的新工具
Timothy O'Sullivan1,2, Mayenaaz Sidhu1,2, Sunil Gupta1,2
1Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia.
一个新的EMR病例选择分数 (EMR-CSS) 帮助初学者内镜医生识别具有挑战性的大型非脚踏式结肠多体 (LNPCPs). 该工具通过预测困难病例,有助于安全和成功的内镜粘膜切除 (EMR) 培训.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 医学教育 医学教育
背景情况:
- 对于大型非形结肠聚体 (LNPCPs) 的内镜粘膜切除 (EMR) 正在扩展到专家中心之外.
- 缺乏用于EMR病例选择的特定工具对初学者内镜师构成挑战.
- 培训对于防止切除失败和不必要的手术转诊至关重要.
研究的目的:
- 开发一个EMR病例选择分数 (EMR-CSS).
- 为了确定可能具有挑战性的LNPCPs,为内镜医生新的EMR.
- 在早期EMR培训中提高能力和安全.
主要方法:
- 在130个月内招募了连续的LNPCPEMR病例.
- 记录了病变特征,程序数据和不良事件.
- 确定了程序内出血 (IPB),程序内穿孔 (IPP) 或未成功切除的预测变量,以形成数值得分.
主要成果:
- 在1993年的LNPCP中,26.4%的结果是复合的 (IPB,IPP或EMR失败).
- 损伤大小,具有挑战性的位置和状形态预测了复合结果.
- 一个6点的EMR-CSS与2的切断显示了81%的敏感性对具有挑战性的案例.
结论:
- 该EMR-CSS是EMR培训的一个新工具.
- 它识别了腺瘤性LNPCP,适合培训人员安全和成功的EMR尝试.
- 在早期EMR学习曲线中促进适当的案例选择.
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