Original Article
Analysis of endoscopic submucosal dissection training system construction
Min Chen, Yuling Yao, Xiaoqi Zhang, Lei Wang, Ying Lyu, Xiaoping Zou, Tingsheng Ling
Published 2020-01-20
Cite as Chin J Dig Endosc, 2020, 37(1): 22-27. DOI: 10.3760/cma.j.issn.1007-5232.2020.01.005
Abstract
ObjectiveTo investigate the prerequisites for endoscopists, who were chosen to receive endoscopic submucosal dissection (ESD) training.
MethodsA total of 41 trainees, who attended ESD training in the endoscopic center of Nanjing Drum Tower Hospital from January 2017 to June 2018 were enrolled in the study. The general information of the subjects were collected, including name, age, gender, the number of gastroscopy and colonoscopy independently performed before training, the independent usage of narrow band image (NBI), magnifying endoscopy (ME), endoscopic mucosal resection (EMR), ESD, endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP) before training. And then every trainee independently finished four in vitro experiments of pig esophagus ESD. The specimen area and operating time were recorded, and the operating speed was calculated. Linear regression analysis was used to analyze the affecting factors of operating speed of ESD.
ResultsAmong the 41 trainees, 26 were male and 15 were female, with age of 36.07±4.44 years. The specimen area, operating time and operating speed of pig esophagus ESD was 4.67±1.61 cm2, 24.54±5.97 min, and 0.19±0.05 cm2/min, respectively. Univariate linear regression analysis showed that the number of gastroscopy (n>5 000, P=0.001 8) and colonoscopy (n>3 000, P=0.000 1), the detect number of early cancer in upper digestive tract (n>30, P=0.000 3) and lower digestive tract (n>10, P=0.019 7), and the usage of ME (P=0.047 8), EMR (P=0.019 6) and ESD (P=0.000 3) before training were statistically correlated with the operating speed of ESD. Carrying out NBI (P=0.532 9), ERCP (P=0.500 7) and EUS (P=0.766 8) before training were not statistically correlated with the operating speed of ESD. The operating speed of ESD was negatively correlated with the perforation rate of ESD (P<0.000 1). According to multivariable linear regression model, the usage of EMR (P=0.029) and ESD (P=0.034) were statistically correlated with the operating speed of ESD.
ConclusionESD trainees, who have the number of gastroscopy more than 5 000, the number of colonoscopy more than 3 000, the detect number of early cancer more than 30 in upper digestive tract and 10 in lower digestive tract, and the usage of ME, EMR and ESD before training, can get a better training effect. The study provides a theoretical basis for selecting appropriate ESD trainees.
Key words:
Animal models; In vitro; Endoscopic submucosal dissection; Operating training; Dissection time
Contributor Information
Min Chen
Department of Gastroenterology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Yuling Yao
Department of Gastroenterology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Xiaoqi Zhang
Department of Gastroenterology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Lei Wang
Department of Gastroenterology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Ying Lyu
Department of Gastroenterology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Xiaoping Zou
Department of Gastroenterology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Tingsheng Ling
Department of Gastroenterology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Department of Gastroenterology, Nanjing Gaochun People′s Hospital, Nanjing 211300, China
