掌握胃内镜下粘膜切割:由西方内镜医生进行的100多个连续病例的学习曲线分析
Josué Aliaga Ramos1,2, Vitor Nunes Arantes3,4
1Service of Gastroenterology, Hospital José Agurto Tello-Chosica, 150118, Lima 15, Peru.
World journal of gastrointestinal endoscopy
|February 17, 2026
概括
在胃内镜下粘膜切割 (ESD) 中取得熟练程度需要在西方中心进行100多项手术. 这项研究强调了系统培训和逐步增加病例复杂性的重要性,以确保安全有效的胃ESD.
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
- 在瘤学瘤学.
背景情况:
- 胃内镜下粘膜切割 (ESD) 是切除表面胃瘤,特别是早期胃腺癌的关键最小侵入性技术.
- 虽然已在亚洲建立,但其在西方内镜单位的采用正在增加.
研究的目的:
- 在一个重要的西方患者队列中评估胃ESD的学习曲线.
- 确定达到熟练程度所需的程序数量.
主要方法:
- 一项对2009年至2025年期间进行的164项胃ESD手术的回顾性分析.
- 患者被分为四个时间阶段 (40个病例),以跟踪结果的变化.
- 分析的关键指标包括手术时间,块切除率,完全切除 (R0),治愈切除率和不良事件.
主要成果:
- 该研究观察了四个阶段的程序结果的趋势.
- 虽然最初的阶段显示出高的阻塞和完全切除率,但后来的阶段显示出略有下降,并增加了不良事件 (尽管在统计学上并不显著).
- 在112号病例周围确定了熟练度的转折点,这表明需要100多个程序.
结论:
- 在西方环境中,熟练掌握胃ESD通常在经过100多次手术后才能实现.
- 严格,系统的培训与程序复杂性的逐步增加相结合,对于保持高安全性和有效性标准至关重要.
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