Experimental gastric endoscopic submucosal dissection: training in a porcine model
| Autor: | Panagiotis Kasapidis, Konstantina D. Paraskeva, Georgios Mavrogenis, Theodoros Emmanouil, Vassilios Panteris, Dimitrios K. Christodoulou, Georgios Tribonias, John K Triantafillidis, Konstantinos Delis, Takataro Fukuhara, Yoriaki Komeda, Zacharias P. Tsiamoulos, Hiroshi Kashida, Apostolos Papalois, Stefanos P. Bassioukas, Sotirios D. Georgopoulos |
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| Rok vydání: | 2017 |
| Předmět: |
hands-on course
medicine.medical_specialty business.industry Perforation (oil well) Gastroenterology procedural time Endoscopic submucosal dissection animal models Experimental research Surgery Low volume 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis ESD training Medicine Original Article 030211 gastroenterology & hepatology Training program business Human colon Procedure time |
| Zdroj: | Annals of Gastroenterology |
| ISSN: | 1792-7463 |
| Popis: | Background Endoscopic submucosal dissection (ESD) requires special skills and a long procedure time for a quality-controlled procedure. A universal training system remains to be established. Hands-on courses in animal models before advancing to the human colon appear to be essential, especially in Europe. The learning curve is a prerequisite in ESD, in order to improve technical outcomes and decrease the rate of procedural adverse events. Methods In the experimental research center of ELPEN Pharmaceuticals, 18 European endoscopists, inexperienced at ESD, performed gastric ESDs in porcine models. The course lasted two days and was conducted under the supervision of experts. Results A total of 72 of 76 ESDs were completed en bloc (94.7%). The procedural time and cutting speed differed significantly between the first and second day: 48±4.4 vs. 43±4.8 min (P=0.0045), and 1.38±0.20 vs. 1.63±0.23 cm2/min (P=0.0033), respectively. The complications were not significantly different between the two groups: five (13.88%) vs. four (11%) episodes of bleeding (P>0.05). The perforation rate was similar, at two episodes per day (5.55%). We documented an acceptable rate of en bloc resections and complications. Conclusion ESD demands a new level of endoscopic skills in Europe. A formal sequential training program, using porcine models, may benefit countries with a low volume of cases. Keywords Endoscopic submucosal dissection, animal models, ESD training, hands-on course, procedural time Ann Gastroenterol 2017; 30 (4): 446-449 |
| Databáze: | OpenAIRE |
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