García-Rodríguez Ana, Fernández-Esparrach Gloria, Sendino Oriol, Ginès Angels
Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, CIBERehd, IDIBAPS, Universitat de Barcelona, Barcelona, España.
Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, CIBERehd, IDIBAPS, Universitat de Barcelona, Barcelona, España.
Gastroenterol Hepatol. 2018 Dec;41(10):672-678. doi: 10.1016/j.gastrohep.2018.06.009. Epub 2018 Jul 27.
To understand the current state of endoscopic ultrasonography (EUS) in Spain.
Descriptive analysis from a national survey with 11 questions: 10 related to technique and 1 to the training and experience of the endoscopists.
Sixty endoscopists from 48 of the 97 (49.5%) hospitals that perform EUS in Spain responded to the survey. A total of 28,678 procedures (20,311 diagnostic, 7,446 with puncture and 921 therapeutic) were recorded over the course of one year. Approximately 64% of the hospitals perform between 300 and 999 tests per year. All have radial and sectorial echoendoscopes, with a median of 2 (2-8) scopes. For cytological diagnosis, the 22-gauge needle is the most commonly used (98%) and, for histological diagnosis, the Procore (72%). The study of the pancreas and bile duct is the most common indication for diagnostic EUS (60%), followed by the staging of digestive tract neoplasms (20%). Approximately 72% of the hospitals perform on-site cytopathology evaluations and sedation is administered in equal parts by both endoscopists and anaesthetists. In terms of experience, 45% of echoendoscopists perform fewer than 300 annual exams and the median training duration is 6months (0.5-36).
EUS is adequately implemented in Spain and good equipment is available. However, it is necessary to establish a standardised EUS training program since the one undertaken by many echoendoscopists could prove insufficient according to the standards established by Scientific Societies.
了解西班牙内镜超声检查(EUS)的现状。
通过一项包含11个问题的全国性调查进行描述性分析:10个问题与技术相关,1个问题与内镜医师的培训和经验有关。
西班牙97家开展EUS的医院中有48家(49.5%)的60位内镜医师回复了调查。在一年的时间里共记录了28678例操作(20311例诊断性操作、7446例穿刺操作和921例治疗性操作)。约64%的医院每年进行300至999次检查。所有医院都有径向和扇形超声内镜,超声内镜数量中位数为2(2 - 8)台。对于细胞学诊断,最常用的是22号针(98%),对于组织学诊断,最常用的是Procore(72%)。胰腺和胆管检查是诊断性EUS最常见的适应证(60%),其次是消化道肿瘤分期(20%)。约72%的医院进行现场细胞病理学评估,内镜医师和麻醉医师实施镇静的比例相同。在经验方面,45%的超声内镜医师每年进行的检查少于300次,培训时间中位数为6个月(0.5 - 36个月)。
EUS在西班牙得到了充分实施,且设备良好。然而,有必要建立标准化的EUS培训项目,因为根据科学学会制定的标准,许多超声内镜医师所接受的培训可能不足。