美国内镜下粘膜剖析 (ESD) 的学习曲线:大型,未受指导的,单操作员的经验
Mai A Khalaf1,2, Fares Ayoub1, Kristen A Staggers3
1Gastroenterology, Baylor College of Medicine, Houston, United States.
Endoscopy international open
|July 26, 2024
概括
这项研究分析了西方患者内镜下层剖析 (ESD) 的学习曲线. 在250-350个案例中实现了能力,为未来的培训计划提供了信息.
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
背景情况:
- 内镜下粘膜切割 (ESD) 能够使瘤在阻隔状态下被去除.
- 西方对ESD的采用受到其的学习曲线的限制.
- 西方人口中ESD学习曲线的数据很少.
研究的目的:
- 分析在美国执行ESD的单个内镜医生的学习曲线.
- 确定在ESD方面取得能力所需的案件数量.
主要方法:
- 一个内镜医生 (2015-2022) 连续进行的515次ESD手术的回顾性分析.
- 使用了描述性统计和累计总和 (CUSUM) 分析.
- 评估区块切除,R0切除和切除速度.
主要成果:
- En-bloc,R0和治愈切除率分别为81.9%,71.1%和68.4%.
- 学习曲线停滞在268个案例 (en-bloc),347个案例 (R0),170个案例 (速度>9cm2/hr).
- 结肠ESD能力是在185个En-bloc和R0切除病例后达到的.
结论:
- 一位经验丰富的操作人员在实体培训后,在250-350个程序之间获得了ESD能力.
- 结果可以指导西方ESD培训计划的发展.
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