Kawasato Ryo, Hashimoto Shinichi, Shirasawa Tomohiro, Goto Atsushi, Okamoto Takeshi, Nishikawa Jun, Sakaida Isao
Department of Gastroenterology and Hepatology.
Department of Laboratory Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Clin Exp Gastroenterol. 2017 Jan 5;10:1-7. doi: 10.2147/CEG.S120544. eCollection 2017.
To investigate which colonoscopy (CS) cases should be presided over by endoscopists in training, using factors including obesity and metabolic syndrome.
Items investigated were sex, age, body mass index (BMI), waist circumference, hypertension, diabetes, hyperlipidemia, history of abdominal surgery (excluding colectomy), colon diverticulosis, prescription of antithrombotic agents, and quality of bowel preparation. Expert physicians were defined as those with at least 9 years of endoscopy experience; all other physicians were defined as being in training. In a retrospective analysis, cases in which a physician in training reached the cecum within 15 minutes without requiring the involvement of the supervising physician were defined as eligible cases over which a physician in training should preside, while other cases were defined as non-eligible.
Overall, 813 CS cases were analyzed. Males (<0.0001), cases started by an expert physician (<0.0001), cases of no fellow physician involvement (<0.0001), and cases with good bowel preparation (<0.0001) had significantly shorter cecal intubation times. Of the 562 cases presided over by a physician in training, 194 were deemed eligible and 368 non-eligible. The eligible cases had a higher proportion of males (=0.017), younger age (=0.033), higher BMI (=0.034), and higher rates of hypertension (=0.001) and good bowel preparation (=0.001). In analysis by sex, males demonstrated significantly more eligible cases among younger patients (=0.009) and those with good bowel preparation (=0.008), while there were significantly more eligible cases among females with hypertension (=0.004).
It may be useful to select CS cases for physicians considering sex, age, BMI, hypertension, and bowel preparation.
利用肥胖和代谢综合征等因素,调查哪些结肠镜检查(CS)病例应由实习内镜医师主持。
调查的项目包括性别、年龄、体重指数(BMI)、腰围、高血压、糖尿病、高脂血症、腹部手术史(不包括结肠切除术)、结肠憩室病、抗血栓药物处方以及肠道准备质量。专家医师定义为具有至少9年内镜检查经验的医师;所有其他医师定义为实习医师。在一项回顾性分析中,实习医师在15分钟内到达盲肠且无需上级医师参与的病例定义为实习医师应主持的合格病例,而其他病例定义为不合格病例。
总体分析了813例CS病例。男性(<0.0001)、由专家医师开始的病例(<0.0001)、无其他医师参与的病例(<0.0001)以及肠道准备良好的病例(<0.0001)的盲肠插管时间明显更短。在实习医师主持的562例病例中,194例被认为合格,368例不合格。合格病例中男性比例更高(=0.017)、年龄更小(=0.033)、BMI更高(=0.034),高血压发生率更高(=0.001)且肠道准备良好(=0.001)。按性别分析,年轻男性(=0.009)和肠道准备良好的男性(=0.008)中合格病例明显更多,而高血压女性中合格病例明显更多(=0.004)。
考虑性别、年龄、BMI、高血压和肠道准备情况为医师选择CS病例可能是有用的。