欧洲内镜下粘膜剖析的实施:在10次ESD专家培训研讨会之后的调查,2009年至2018年
Tsuneo Oyama1, Naohisa Yahagi2, Thierry Ponchon3
1Department of Endoscopy, Saku Central Hospital Advanced Care Center, Saku, Japan.
iGIE : innovation, investigation and insights
|February 6, 2026
概括
在西方中心无监督实施内镜下粘膜切割 (ESD) 显示出成功,特别是在结直肠手术中. 持续培训对于实现专业级别的ESD表现和成果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 医疗培训 医学培训
背景情况:
- 来自日本的内镜下层剖析 (ESD) 采用需要监督培训.
- 西方中心在临床上实施ESD方面面临挑战.
- 本研究评估了无监督ESD实施的结果.
研究的目的:
- 评估西方中心无监督内镜下层剖析 (ESD) 的性能和安全性.
- 分析培训量对ESD成果的影响.
- 在西方环境中评估ESD对早期胃肠道癌症的可行性.
主要方法:
- 在135个西方推中心,向高级参与者分发了一份横截面问卷调查.
- 该调查收集了关于ESD表现,器官分布和治疗意向病例的严重不良事件的数据.
- 分析了来自113个中心 (84%的响应率) 的数据,根据ESD经验对中心进行分类.
主要成果:
- 61.5%的中心进行了ESD,其中21个中心 (16%) 被归类为"专业" (>150个ESD).
- 结肠直肠ESD占大多数 (66-68%),30天死亡率低 (0.03%) 和令人满意的瘤结果.
- 与初始学习中心 (64%) 相比,拥有>30个ESD的中心显示出更高的封锁切除率 (84%).
结论:
- 无监督的ESD实施在结直肠中是可行的,并且使用阶段式方法在结直肠中取得了成功.
- 西方的ESD中心应致力于专业水平的表现 (>80%的治愈性ESD).
- 需要进一步的研究和标准化的培训途径,以优化全球的ESD采用.
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