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一种用于超声内镜引导下细针穿刺活检(EUS-FNA)培训的新型猪模型的验证(附视频)

Validation of a novel swine model for training in EUS-FNA (with videos).

作者信息

Li Jun, Yao Jun, Li Shiyu, Wang Shimin, Zhou Wei, Jin Zhendong, Wang Kaixuan

机构信息

Department of Gastroenterology, Changhai Hospital, Navy Medical University, Shanghai, China.

Department of Gastroenterology, Shenzhen People's Hospital, Guangdong Province, China.

出版信息

Endosc Ultrasound. 2020 Jul-Aug;9(4):232-237. doi: 10.4103/eus.eus_13_20.

Abstract

BACKGROUND AND OBJECTIVES

EUS-FNA is applied widely in clinical practice, but there remains a lack of authentic training models. The present study aimed to develop a novel swine training model and to perform a preliminary assessment of its feasibility and efficacy.

MATERIALS AND METHODS

To create an internal lesion-like target, empty shells of iodine-125 seeds were implanted into the caudate lobe of the liver in Bama minipigs. A training program involving 10 trainees was subsequently carried out, in which a total of 60 needlings were performed, composed of 6 for each trainee obtained during two training steps. Comparisons of procedure-related variables were conducted between the two. Trainees completed a questionnaire to assess their basic endoscopic experiences and reasonability of the model.

RESULTS

A target region of 2.0 cm × 2.0 cm in diameter was successfully established on the caudate lobe in all implanted pigs. In the training program, the average procedure time decreased from the first to the second step and the average time for the total 30 needlings' obtainment was significantly shorter for the second training step (23.8 ± 4.5 min vs. 40.9 ± 9.0 min, P < 0.001). For the second step, there was also a significant improvement in total success rate (86.7% vs. 56.7%, P = 0.020) and accuracy rate (76.7% vs. 43.3%, P = 0.017). All trainees scored the effectiveness of the model highly and all reported improved confidence after the training.

CONCLUSION

This novel swine training model could authentically mimic clinical EUS-FNA, providing an effective in vivo practice tool for novices before clinical practice.

摘要

背景与目的

超声内镜引导下细针穿刺抽吸术(EUS-FNA)在临床实践中应用广泛,但仍缺乏可靠的训练模型。本研究旨在开发一种新型猪训练模型,并对其可行性和有效性进行初步评估。

材料与方法

为创建内部病灶样靶点,将碘-125种子空壳植入巴马小型猪肝脏尾状叶。随后对10名学员开展了一项培训计划,共进行60次穿刺,每个学员在两个训练阶段各进行6次穿刺。对两者之间的操作相关变量进行比较。学员完成一份问卷,以评估他们的基本内镜经验和模型的合理性。

结果

所有植入猪的肝脏尾状叶均成功建立了直径2.0 cm×2.0 cm的靶区。在培训计划中,平均操作时间从第一步到第二步有所减少,第二次训练阶段获取全部针道的平均时间明显更短(23.8±4.5分钟对40.9±9.0分钟,P<0.001)。对于第二步,总成功率(86.7%对56.7%,P=0.020)和准确率(76.7%对43.3%,P=0.017)也有显著提高。所有学员对模型的有效性评价很高,且所有学员均表示培训后信心增强。

结论

这种新型猪训练模型能够真实模拟临床EUS-FNA,为新手在临床实践前提供了一种有效的体内实践工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38e9/7529007/a0ba68d1ebd8/EUS-9-232-g001.jpg

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