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在普通外科住院医师培训中实现内镜操作能力。

Achieving endoscopic competency in a general surgery residency.

作者信息

Barnes Lindsey J, Unruh Mitchell, Drake Rachel M, Helmer Stephen D, Ammar Alex D, Osland Jacqueline S

机构信息

Department of Surgery, The University of Kansas School of Medicine-Wichita, 929 North Saint Francis Street, Room 3082, Wichita, KS 67214, USA.

Department of Surgery, The University of Kansas School of Medicine-Wichita, 929 North Saint Francis Street, Room 3082, Wichita, KS 67214, USA; Department of Medical Education, Via Christi Hospital Saint Francis, Wichita, KS, USA.

出版信息

Am J Surg. 2014 Dec;208(6):1035-9; discussion 1038-9. doi: 10.1016/j.amjsurg.2014.06.031. Epub 2014 Sep 22.

Abstract

BACKGROUND

In 2006, the Residency Review Committee for Surgery increased the total number of required endoscopy cases for graduating residents. Our goal was to evaluate general surgery resident competency in endoscopy, focusing on quality measures.

METHODS

A 9-year retrospective review was conducted of 29 residents. Total number of endoscopies performed throughout residency was recorded. Procedures performed as fifth-year residents with indirect supervision were evaluated for quality measures.

RESULTS

An average of 76 esophagogastroduodenoscopies and 147 colonoscopies were performed through their first 4 years of residency. Chief residents performed an average of 16 esophagogastroduodenoscopies and 22 colonoscopies. Of colonoscopies performed during their fifth year, 191 were performed while the resident had only indirect supervision. During these cases, cecal intubation was achieved in 90.6% of cases, an average of .48 polyps were identified, and average scope withdrawal time was 13.4 ± 7.1 minutes.

CONCLUSIONS

Our data indicate that surgery residents achieve competency in colonoscopy before performing 140 colonoscopies, supporting the concept that surgery residencies can function as an excellent training ground for endoscopy.

摘要

背景

2006年,外科住院医师评审委员会增加了毕业住院医师所需的内镜检查病例总数。我们的目标是评估普通外科住院医师在内镜检查方面的能力,重点关注质量指标。

方法

对29名住院医师进行了为期9年的回顾性研究。记录了整个住院期间进行的内镜检查总数。对在间接监督下作为五年级住院医师进行的手术进行质量指标评估。

结果

在住院的前4年中,平均进行了76次食管胃十二指肠镜检查和147次结肠镜检查。主任医师平均进行了16次食管胃十二指肠镜检查和22次结肠镜检查。在他们五年级期间进行的结肠镜检查中,有191次是在住院医师仅接受间接监督的情况下进行的。在这些病例中,90.6%的病例实现了盲肠插管,平均发现0.48个息肉,平均退镜时间为13.4±7.1分钟。

结论

我们的数据表明,外科住院医师在进行140次结肠镜检查之前就具备了结肠镜检查能力,这支持了外科住院医师培训可以成为内镜检查的优秀训练场这一观点。

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