Nakajima Takahiro, Fujiwara Taiki, Saegusa Fumie, Inage Terunaga, Sakairi Yuichi, Wada Hironobu, Suzuki Hidemi, Iwata Takekazu, Yoshida Shigetoshi, Nakatani Yukio, Yoshino Ichiro
Department of General Thoracic Surgery, Chiba University Graduate School of Medicine Division of Pathology, Chiba University Hospital Department of Diagnostic Pathology, Chiba University Graduate School of Medicine, Chiba, Japan.
Medicine (Baltimore). 2017 Mar;96(13):e6513. doi: 10.1097/MD.0000000000006513.
Training for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has focused on the procedure itself; however, the techniques for obtaining adequate sample are also important for achieving a pathological diagnosis as well as for molecular testing. The aim of this study was to evaluate the feasibility and efficacy of a biosimulator for training subjects in adequate sample acquisition during EBUS-TBNA.A total of 19 bronchoscopists voluntarily participated in this study. A biosimulator (ArtiCHEST, HARADA Corporation, Tokyo, Japan) was used for the training. After a 10-minute briefing, the first pass was performed by pairs of trainees. The trainees then received a 30-minute lecture that focused on the acquisition of samples using EBUS-TBNA. The trainees next performed their second pass under the supervision of the trainers. Each participant obtained a cytological smear that was coded and evaluated for quantity as well as quality by an independent cytotechnologist.The trainees had an average of 5.9 years of bronchoscopy experience. With regard to the quantity evaluation, 9 (47.4%) subjects sampled a greater number of lymphocytes on the second pass than on the first, whereas 2 were better on the first pass, and the others sampled roughly the same amount both times. With regard to the quality assessment, 9 (47.4%) subjects obtained better quality samples on the second pass, whereas the quality of the first and second pass was deemed to be roughly the same for the remaining subjects.A biosimulator can be used to train doctors in specimen acquisition and evaluate their skills with sampling using EBUS-TBNA.
支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）的培训一直聚焦于操作本身；然而，获取足够样本的技术对于实现病理诊断以及分子检测也很重要。本研究的目的是评估一种生物模拟器在EBUS-TBNA期间训练受试者获取足够样本的可行性和有效性。
共有19名支气管镜医师自愿参与了本研究。使用了一种生物模拟器（ArtiCHEST，日本东京原田公司）进行培训。在进行10分钟的讲解后，由成对的学员进行首次穿刺。然后，学员们接受了一场30分钟的讲座，重点是使用EBUS-TBNA获取样本。接下来，学员们在培训师的监督下进行第二次穿刺。每位参与者都获得了一份细胞学涂片，由一名独立的细胞技术专家对其进行编码，并对数量和质量进行评估。
学员们的支气管镜检查经验平均为5.9年。在数量评估方面，9名（47.4%）受试者在第二次穿刺时采集的淋巴细胞数量比第一次多，而2名受试者第一次表现更好，其他受试者两次采集的数量大致相同。在质量评估方面，9名（47.4%）受试者在第二次穿刺时获得了质量更好的样本，而其余受试者第一次和第二次穿刺的质量被认为大致相同。
生物模拟器可用于培训医生进行标本采集，并使用EBUS-TBNA评估他们的采样技能。
