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实习生结肠镜检查腺瘤检出率分析。

Analysis of adenoma detection rate of colonoscopy among trainees.

作者信息

Song Young Min, Han Kyung Su, Kim Byung Chang, Hong Chang Won, Kim Bun, Kim Min Chul, Jin Myeong Jae, Sohn Dae Kyung

机构信息

Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.

出版信息

Ann Coloproctol. 2024 Dec;40(6):548-554. doi: 10.3393/ac.2023.00199.0028. Epub 2024 Aug 28.

Abstract

PURPOSE

To analyze adenoma detection rate (ADR) and related quality indicators of colonoscopy among trainees and make recommendations for appropriate colonoscopy training.

METHODS

ADR and related indicators of colonoscopies performed by 3 trainees and 5 colonoscopy experts between March and November 2022 were analyzed. These indicators were analyzed in both the entire patients and the screening/surveillance group. In addition, the training period of the 3 trainees was divided into 3 sections, and the changes in these indicators were examined.

RESULTS

The mean ADR of the 3 trainees was 50.6%. In the screening/surveillance group, the mean ADR of the 3 trainees was 51.8%, showing no significant difference from the experts' ADR (53.4%). When the training period was divided into 3 sections and analyzed in the screening/surveillance group, the mean ADR of the trainees gradually increased to 49.4%, 52.6%, and 53.6%, respectively; however, the difference was insignificant. Analyzing each trainee's ADR, there was a significant difference among the 3 trainees (58.5% vs. 44.7% vs. 50.2%, P=0.008). However, in the third section of the training period, the 3 trainees' ADRs were 53.0%, 49.2%, and 57.3%, respectively, showing no significant difference (P=0.606).

CONCLUSION

In the early stages of training, the ADR was higher than recommended; however, there were variances in ADR between individuals. As the training period passed, the ADR became similar at the expert level, whereas the difference in ADR between trainees decreased. Therefore, efforts to increase ADR should be made actively from the beginning of training and continued during the training period.

摘要

目的

分析实习医生结肠镜检查的腺瘤检出率(ADR)及相关质量指标,并为适当的结肠镜检查培训提出建议。

方法

分析了2022年3月至11月期间3名实习医生和5名结肠镜检查专家进行的结肠镜检查的ADR及相关指标。这些指标在所有患者以及筛查/监测组中进行了分析。此外,将3名实习医生的培训期分为3个阶段,并检查这些指标的变化。

结果

3名实习医生的平均ADR为50.6%。在筛查/监测组中,3名实习医生的平均ADR为51.8%,与专家的ADR(53.4%)无显著差异。当将培训期分为3个阶段并在筛查/监测组中进行分析时,实习医生的平均ADR分别逐渐升至49.4%、52.6%和53.6%;然而,差异不显著。分析每名实习医生的ADR,3名实习医生之间存在显著差异(58.5%对vs . 44.7%对vs . 50.2%,P = 0.008)。然而,在培训期的第三阶段,3名实习医生的ADR分别为53.0%、49.2%和57.3%,无显著差异(P = 0.606)。

结论

在培训初期,ADR高于推荐水平;然而,个体之间的ADR存在差异。随着培训期的推移,ADR在专家水平上变得相似,而实习医生之间的ADR差异减小。因此,应从培训开始就积极努力提高ADR,并在培训期间持续进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3134/11701454/7a43f858d552/ac-2023-00199-0028f1.jpg

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