セッション情報 International Session4(消化器内視鏡学会・消化器病学会合同)

Achieving high quality colorectal ESD

タイトル 内IS4-10:

Effective Training System for Learning ESD

演者 K. Nonaka(Department of Gastroenterology, NTT Medical Center Tokyo)
共同演者 I. Koba(Department of Gastroenterology, Yamaga Chuo Hospital), K. Ohata(Department of Gastroenterology, NTT Medical Center Tokyo)
抄録 Aims: The aim of this study was to assess our training system for colorectal Endoscopic Submucosal Dissection (ESD), based on the clinical outcomes for trainees. Patients & Methods: We retrospectively assessed clinical outcomes which was underwent ESD by four trainees who graduated from medical school four to seven years ago and started colorectal ESD in this environment. Training program: The training system of colorectal ESD consists of diagnostic learning and general skill of therapeutic colonoscopy. A colorectal ESD training system has to include instructions on how to use devices, how to make good position and how to plan a strategy. Preoperative colonoscopy is important for image training and making up strategy. A trainee is allowed to perform colorectal ESD only after overcoming these steps. An expert should back up trainees to prevent complications. Results: 200 colorectal ESD cases performed by the trainees from July 2007 to April 2012 were investigated. The en-blocc resection rate was 100%, the mean diameter of resected specimens was 41.2 mm, the mean operation time was 78.2 minutes, self-completion rate was 79.5 %, and the perforation rate was 3.5 %. All perforations were controlled by endoscopic treatment. Conclusion: Our training system enabled to prevent a decline in clinical outcome during the introductory learning period. Intensive study and training at a "High Volume Center" is a safe and effective way to learn colorectal ESD.
索引用語 colorectal ESD, training system