Pearl R K, Nelson R L, Abcarian H, Nyhus L M
Am Surg. 1986 Nov;52(11):577-80.
The clinical value of lower gastrointestinal endoscopy and the requirement of the American Board of Surgery for endoscopic training mandate establishing a program in flexible sigmoidoscopy and colonoscopy for all surgical residents. In a 12-month period, the surgical residents at the authors' institution performed 599 flexible sigmoidoscopic and 116 total colonoscopic examinations under the supervision of two attending colorectal surgeons, with no mortality and a 0.03 per cent morbidity. There was an average of 42 endoscopic examinations per resident for the 3-week training period. Three hundred seventy (62%) of the flexible sigmoidoscopic examinations were for screening and 229 (38%) were for the evaluation of symptomatic patients. Colorectal polyps were identified in 68 patients (11.4%) and carcinoma in 14 patients (1.9%). Forty-nine per cent of the colonoscopic examinations were for endoscopic polypectomy. Sixty-four per cent of patients with more than one adenomatous polyp harbored polyps in different surgical segments of the colon. Every resident was able to perform flexible sigmoidoscopy safely by the end of the 3-week training period, and in addition, the residents rated their endoscopic experience as a valuable part of their surgical training.
下消化道内镜检查的临床价值以及美国外科委员会对内镜培训的要求，规定要为所有外科住院医师建立乙状结肠镜检查和结肠镜检查项目。在12个月的时间里，作者所在机构的外科住院医师在两位结直肠外科主治医师的监督下，进行了599例乙状结肠镜检查和116例全结肠镜检查，无死亡病例，发病率为0.03%。在为期3周的培训期间，每位住院医师平均进行42例内镜检查。62%（370例）的乙状结肠镜检查用于筛查，38%（229例）用于对有症状患者的评估。68例患者（11.4%）发现结直肠息肉，14例患者（1.9%）发现癌。49%的结肠镜检查用于内镜下息肉切除术。64%有多个腺瘤性息肉的患者，其息肉位于结肠的不同手术节段。到3周培训期结束时，每位住院医师都能安全地进行乙状结肠镜检查，此外，住院医师们将他们的内镜检查经历评为外科培训的重要组成部分。
