Toba Takahito, Ishii Tsuyoshi, Sato Nobuyuki, Nogami Akira, Hojo Aya, Shimizu Ryo, Fujimoto Ai, Matsuda Takahisa
Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan.
Clin Endosc. 2025 Jan;58(1):94-101. doi: 10.5946/ce.2024.108. Epub 2024 Nov 4.
BACKGROUND/AIMS: The efficacy of endoscopic submucosal dissection (ESD) for early-stage gastric cancer is well established. However, its acquisition is challenging owing to its complexity. In Japan, G-Master is a novel ex vivo gastric ESD training model. The effectiveness of training using G-Master is unknown. This study evaluated the efficacy of gastric ESD training using the G-Master to evaluate trainees' learning curves and performance.
Four trainees completed 30 ESD training sessions using the G-Master, and procedure time, resection area, resection completion, en-bloc resection requirement, and perforation occurrence were measured. Resection speed was the primary endpoint, and learning curves were evaluated using the Cumulative Sum (CUSUM) method.
All trainees completed the resection and en-bloc resection of the lesion without any intraoperative perforations. The learning curves covered three phases: initial growth, plateau, and late growth. The transition from phase 1 to phase 2 required a median of 10 sessions. Each trainee completed 30 training sessions in approximately 4 months.
Gastric ESD training using the G-Master is a simple, fast, and effective method for pre-ESD training in clinical practice. It is recommended that at least 10 training sessions be conducted.
背景/目的:内镜黏膜下剥离术(ESD)治疗早期胃癌的疗效已得到充分证实。然而,由于其操作复杂,掌握该技术具有挑战性。在日本,G-Master是一种新型的离体胃ESD训练模型。使用G-Master进行训练的效果尚不清楚。本研究评估了使用G-Master进行胃ESD训练对学员学习曲线和操作表现的效果。
四名学员使用G-Master完成了30次ESD训练课程,并测量了手术时间、切除面积、切除完成情况、整块切除要求和穿孔发生率。切除速度是主要终点,并使用累积和(CUSUM)方法评估学习曲线。
所有学员均完成了病变的切除和整块切除,术中无任何穿孔发生。学习曲线包括三个阶段:初始增长期、平台期和后期增长期。从第1阶段过渡到第2阶段平均需要10次课程。每位学员在大约4个月内完成了30次训练课程。
使用G-Master进行胃ESD训练是临床实践中ESD术前训练的一种简单、快速且有效的方法。建议至少进行10次训练课程。