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使用结肠模拟器时,双气囊结肠镜检查的盲肠插管率高于传统结肠镜检查。

Double-Balloon Colonoscopy Has a Higher Cecal Intubation Rate Than Conventional Colonoscopy Using a Colon Simulator.

作者信息

Sunada Keijiro, Shinozaki Satoshi, Yano Tomonori, Hayashi Yoshikazu, Sakamoto Hirotsugu, Lefor Alan Kawarai, Yamamoto Hironori

机构信息

Division of Gastroenterology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.

Shinozaki Medical Clinic, Tochigi, Japan.

出版信息

Dig Dis Sci. 2017 Apr;62(4):979-983. doi: 10.1007/s10620-017-4477-2. Epub 2017 Feb 13.

Abstract

BACKGROUND/AIM: Cecal intubation using conventional colonoscopy (CC) requires substantial training. We hypothesized that double-balloon colonoscopy (DBC) facilitates cecal intubation by endoscopy naïve operators. The aim of this study is to evaluate the cecal intubation rate and learning curve of DBC compared with CC.

METHODS

Eighteen endoscopy naïve medical students were allocated to two groups and attempted cecal intubation within 20 min using a colon simulator. In group A, CC was performed ten times and then DBC ten times. In group B, the reverse was carried out. We evaluated the cecal intubation rate and learning curve.

RESULTS

The overall success rate for cecal intubation using DBC was significantly superior to CC [132/180 (73%) vs. 12/180 (7%), p < 0.001]. To evaluate the success rate overtime, we divided the ten repetitions of the procedure into three time periods: first (1-3), second (4-6), and third (7-10). The success rate using CC is <20%, even during the third time period, in both groups, and one perforation occurred. The success rate using DBC is over 30% in the first period and increased to nearly 80% in the third period in both groups. Finally, we evaluated the time needed for cecal intubation using DBC. The mean cecal intubation time in the first period is 14 min and decreased to 11 min in the third period.

CONCLUSIONS

DBC has a higher cecal intubation rate than CC performed by endoscopy naïve medical students using a colon simulator in this randomized-controlled, cross-over study.

摘要

背景/目的:使用传统结肠镜检查(CC)进行盲肠插管需要大量训练。我们推测,双气囊结肠镜检查(DBC)有助于未经内镜培训的操作人员进行盲肠插管。本研究的目的是评估与CC相比,DBC的盲肠插管率和学习曲线。

方法

18名未经内镜培训的医学生被分为两组,并使用结肠模拟器在20分钟内尝试进行盲肠插管。A组先进行10次CC,然后进行10次DBC。B组则相反。我们评估了盲肠插管率和学习曲线。

结果

使用DBC进行盲肠插管的总体成功率显著高于CC[132/180(73%)对12/180(7%),p<0.001]。为了评估随时间的成功率,我们将该操作的10次重复分为三个时间段:第一个(1-3次)、第二个(4-6次)和第三个(7-10次)。在两组中,即使在第三个时间段,使用CC的成功率仍<20%,且发生了1例穿孔。两组中使用DBC的成功率在第一个时间段超过30%,在第三个时间段增加到近80%。最后,我们评估了使用DBC进行盲肠插管所需的时间。第一个时间段的平均盲肠插管时间为14分钟,在第三个时间段降至11分钟。

结论

在这项随机对照交叉研究中,使用结肠模拟器时,未经内镜培训的医学生进行DBC的盲肠插管率高于CC。

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