Authors: Masao Yoshida Naomi Kakushima Keita Mori Kimihiro Igarashi Noboru Kawata Masaki Tanaka Kohei Takizawa Sayo Ito Kenichiro Imai Kinichi Hotta Hirotoshi Ishiwatari Hiroyuki Matsubayashi Hiroyuki Ono
Publish Date: 2016/12/30
Volume: 31, Issue: 9, Pages: 3614-3622
Abstract
Although endoscopic submucosal dissection ESD represents a significant progress in therapeutic endoscopy little is known about how trainees attain its technical proficiency The aims of this study were to evaluate the learning curve and clinical outcomes of gastric ESD performed by trainee endoscopistsBetween April 2009 and March 2014 334 gastric ESD procedures were performed by seven trainees 42–50 consecutive cases per trainee The learning curve for gastric ESD was evaluated using the cumulative sum CUSUM method Longterm outcomes were also analyzedThe calculated CUSUM learning curve comprised three phases Phase I the initial 15 cases Phase II the middle 15 cases and Phase III the final 20 cases The resection speed was 57 ± 32 min/cm2 in Phase I 47 ± 27 min/cm2 in Phase II and 43 ± 22 min/cm2 in Phase III The resection speed was significantly faster in Phase II than in Phase I p = 0019 The rate of selfcompletion reached more than 95 in Phases II and III The overall complete resection rate was 95 showing no significant differences between the three phases Local recurrence was diagnosed in none of the patients during a median followup of 38 monthsMasao Yoshida Naomi Kakushima Keita Mori Kimihiro Igarashi Noboru Kawata Masaki Tanaka Kohei Takizawa Sayo Ito Kenichiro Imai Kinichi Hotta Hirotoshi Ishiwatari Hiroyuki Matsubayashi and Hiroyuki Ono have no conflicts of interest or financial ties to disclose
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