Hoshi Koki, Irisawa Atsushi, Shibukawa Goro, Yamabe Akane, Fujisawa Mariko, Igarashi Ryo, Yoshida Yoshitsugu, Abe Yoko, Imbe Koh
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Japan.
Endosc Int Open. 2016 Sep;4(9):E1004-8. doi: 10.1055/s-0042-110094. Epub 2016 Aug 5.
Trainees are required to learn EUS-FNA using a model before working with a patient. The aim of the current study was to validate a new training model developed for EUS-FNA.
Several fresh chicken tenderloins were embedded as target lesions in the submucosal layer of an isolated porcine stomach. The stomach was fixed to a plate with nails, and was placed in a tub filled with water. The primary endpoint was feasibility of the newly developed model for EUS-FNA training, evaluated as follows: 1) visualization of the target lesion with blinding for lesion location; 2) penetrability of the needle; 3) sampling rate of macroscopic specimen; and 4) ROSE capability. Secondary endpoints were its durability and utility for multiple EUS-FNA procedures during EUS-FNA training, and the ease and cost of preparing the model.
Six endoscopists (1 expert, 5 trainees) attempted EUS-FNA procedures using this model. The target lesion could be identified clearly, and EUS-FNA could be performed with realistic resistance felt. In addition, rapid on-site evaluation could be easily achieved. Based on 10 needlings by each endoscopist, adequate specimens for histology could be macroscopically taken with an average 85 % success rate. Visibility and maneuverability were maintained throughout all needlings. Preparation time for this model was less than 30 minutes with a total cost of $ 22.
An easy-to-use and inexpensive training model with a realistic feel of needling was created. This model can potentially enable beginners to practice safe and effective EUS-FNA procedures.
实习生在对患者进行操作前，需要使用模型学习超声内镜引导下细针穿刺活检（EUS-FNA）。本研究的目的是验证一种新开发的用于EUS-FNA的训练模型。
将几块新鲜鸡里脊肉作为靶病变包埋在离体猪胃的黏膜下层。用钉子将胃固定在平板上，并置于装满水的桶中。主要终点是新开发的EUS-FNA训练模型的可行性，评估如下：1）在不了解病变位置的情况下对靶病变进行可视化；2）针的穿透性；3）宏观标本的采样率；4）现场快速评估（ROSE）能力。次要终点是其在EUS-FNA训练期间进行多次EUS-FNA操作的耐用性和实用性，以及制备模型的难易程度和成本。
6名内镜医师（1名专家，5名实习生）使用该模型尝试进行EUS-FNA操作。靶病变能够清晰识别，并且可以在感受到真实阻力的情况下进行EUS-FNA。此外，能够轻松实现快速现场评估。基于每位内镜医师进行10次穿刺，平均85%的成功率可宏观获取足够的组织学标本。在所有穿刺过程中，视野和可操作性均得以保持。该模型的制备时间少于30分钟，总成本为22美元。
创建了一种易于使用且成本低廉的训练模型，具有真实的穿刺手感。该模型可能使初学者能够练习安全有效的EUS-FNA操作。
