Boo Sun-Jin, Jung Ji Hoon, Park Jae Ho, Na Soo-Young, Kim Seon Ok, Park Sang Hyoung, Yang Dong-Hoon, Kim Kyung-Jo, Ye Byong Duk, Myung Seung-Jae, Yang Suk-Kyun, Kim Jin-Ho, Byeon Jeong-Sik
Department of Internal medicine, Jeju National University School of Medicine , Jeju , Korea.
Scand J Gastroenterol. 2015 Jul;50(7):908-15. doi: 10.3109/00365521.2015.1006672. Epub 2015 Jan 26.
The purpose of this study is to investigate the learning curve for colonoscopic polypectomy (CP) by trainee endoscopists.
The amount of training required to achieve technical competence for CP is uncertain.
The CP times and en bloc resection rates of three experienced colonoscopists were obtained from 240 procedures. These data were compared to those of three gastroenterology trainees who performed 750 CP procedures. A trainee procedure was deemed to be a success if en bloc resection was obtained and the CP time was within twice the median CP time of the experienced colonoscopists. Trainees were deemed to be technically competent when they achieved a CP success rate of greater than or equal to 80%.
The median CP times and en bloc resection rates for the experienced colonoscopists and trainees were 79 s (range, 20-301 s) and 99.6% (239/240), and 118 s (range, 36-1051 s) and 95.6% (717/750), respectively. The trainee success rate of CP was 72% (540/750). The success rate of the procedure was associated with increased trainee experience (p = 0.003) and reached 80% after 250 procedures. The CP time significantly decreased (p < 0.001) and en bloc resection rate significantly increased (p = 0.011) as trainee experience accumulated. The level of experience was an independent predictor for successful CP.
The achievement of technical competence with CP was associated with an accumulation of approximately 250 procedures. These findings suggest that dedicated education and training programs for CP are warranted.
本研究旨在调查实习内镜医师进行结肠镜息肉切除术（CP）的学习曲线。
获得CP技术能力所需的培训量尚不确定。
从240例手术中获取了三名经验丰富的结肠镜医师的CP时间和整块切除率。将这些数据与三名进行了750例CP手术的胃肠病学实习生的数据进行比较。如果获得整块切除且CP时间在经验丰富的结肠镜医师中位CP时间的两倍以内，则实习生的手术被视为成功。当实习生的CP成功率大于或等于80%时，他们被认为在技术上是胜任的。
经验丰富的结肠镜医师和实习生的中位CP时间和整块切除率分别为79秒（范围20 - 301秒）和99.6%（239/240），以及118秒（范围36 - 1051秒）和95.6%（717/750）。实习生CP成功率为72%（540/750）。手术成功率与实习生经验增加相关（p = 0.003），在250例手术后达到80%。随着实习生经验的积累，CP时间显著缩短（p < 0.001），整块切除率显著提高（p = 0.011）。经验水平是CP成功的独立预测因素。
CP技术能力的获得与大约250例手术的积累相关。这些发现表明有必要开展专门的CP教育培训项目。
