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Impact of a national basic skills in colonoscopy course on trainee performance: An interrupted time series analysis

World Journal of Gastroenterology 2020年第23期26卷 3283-3292页

作者： keith siau James Hodson John T Anderson Roland Valori Geoff Smith Paul Hagan Marietta Iacucci Paul Dunckley Joint Advisory Group on Gastrointestinal Endoscopy Royal College of PhysiciansLondon NW14LEUnited Kingdom NIHR Biomedical Research Centre University of BirminghamBirmingham B152TTUnited Kingdom Institute of Translational Medicine University Hospitals BirminghamBirmingham B152TTUnited Kingdom Department of Gastroenterology Gloucestershire Hospitals NHSFTCheltenham GL537ANUnited Kingdom Department of Gastroenterology Imperial College NHS Foundation TrustLondon NW14LEUnited Kingdom Endoscopy Department Derby Royal HospitalDerby GL13NNUnited Kingdom

BACKGROUND The Joint Advisory Group on Gastrointestinal Endoscopy basic skills in colonoscopy(BSC) course was introduced in 2009 to improve colonoscopy training within the United Kingdom, but its impact on trainee performance is *** To assess whether attendance of the BSC could improve colonoscopy *** Trainees awarded colonoscopy certification between 2011-2016 were stratified into 3 groups according to pre-course procedure count( 140).Study outcomes, comprising the unassisted caecal intubation rate(CIR) and the performance indicator of colonic intubation(PICI), were studied over the 50 procedures pre and post-course. Interrupted time series analyses were performed to detect step-change changes attributable to the *** A total of 369 trainees with pre-course procedure counts of 140(n = 130) were included. Over the 50 pre-course procedures,significant linear improvements in CIR were found, with average increases of 4.2,3.6 and 1.7 percentage points(pp) per 10 procedures performed in the 140 groups respectively(all P 140(86% to 87%;P = 0.354) groups. For PICI, significant step-change improvements were seen in all three groups, with average increases of 5.6 pp(P < 0.001), 5.4 pp(P = 0.003) and 3.9 pp(P = 0.014) *** Attendance of the BSC was associated with a significant step-change improvement in PICI, regardless of prior procedural experience. However, CIR data suggest that the optimal timing of course attendance appears to be at earlier stages of training(< 70 procedures).

关键词： Colonoscopy Training Course Competency development Skills Endoscopy

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Impact of a simulation-based induction programme in gastroscopy on trainee outcomes and learning curves

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World Journal of Gastrointestinal Endoscopy 2020年第3期12卷 98-110页

作者： keith siau James Hodson Peter Neville Jeff Turner Amanda Beale Susi Green Aravinth Murugananthan Paul Dunckley Neil D Hawkes Joint Advisory Group on Gastrointestinal Endoscopy Royal College of PhysiciansLondon NW14LEUnited Kingdom Medical and Dental Sciences University of BirminghamBirmingham B152TTUnited Kingdom Institute of Translational Medicine University Hospitals BirminghamBirmingham B152THUnited Kingdom Department of Gastroenterology Cwm Taf Morgannwg Health BoardLlantrisant CF454SNUnited Kingdom Department of Gastroenterology Cardiff and Vale University Health BoardCardiff CF144XWUnited Kingdom Department of Gastroenterology University Hospitals Bristol NHSFTBristol BS13NUUnited Kingdom Department of Gastroenterology Royal Sussex County HospitalBrighton BN25BEUnited Kingdom Department of Gastroenterology Royal Wolverhampton NHS TrustWolverhampton W100QPUnited Kingdom Department of Gastroenterology Gloucestershire Hospitals NHSFTGloucester GL13NNUnited Kingdom

BACKGROUND Pre-clinical simulation-based training(SBT)in endoscopy has been shown to augment trainee performance in the short-term,but longer-term data are *** To assess the impact of a two-day gastroscopy induction course combining theory and SBT(Structured PRogramme of INduction and Training–SPRINT)on trainee outcomes over a 16-mo *** This prospective case-control study compared outcomes between novice SPRINT attendees and controls matched from a United Kingdom training *** outcomes comprised:(1)Unassisted D2 intubation rates;(2)Procedural discomfort scores;(3)Sedation practice;(4)Time to 200 procedures;and(5)Time to *** Total 15 cases and 24 controls were included,with mean procedure counts of 10 and 3(P=0.739)***-SPRINT,no significant differences between the groups were detected in long-term D2 intubation rates(P=0.332)or discomfort scores(P=0.090).However,the cases had a significantly higher rate of unsedated procedures than controls post-SPRINT(58%vs 44%,P=0.018),which was maintained over the subsequent 200 *** tended to perform procedures at a greater frequency than controls in the post-SPRINT period(median:16.2 vs 13.8 per mo,P=0.051),resulting in a significantly greater proportion of cases achieving gastroscopy certification by the end of follow up(75% vs 36%,P=0.017).CONCLUSION In this pilot study,attendees of the SPRINT cohort tended to perform more procedures and achieved gastroscopy certification earlier than *** data support the role for wider evaluation of pre-clinical induction involving SBT.

关键词： Gastroscopy Esophagogastroduodenoscopy Endoscopy training Induction Competency development Simulation

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Role of endoscopic ultrasound in the characterization of solid pseudopapillary neoplasm of the pancreas

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World Journal of Gastrointestinal Endoscopy 2023年第4期15卷 273-284页

作者： Katarzyna M Pawlak Nadeem Tehami Ben Maher Shujaath Asif Krishn Kant Rawal Daniel Vasile Balaban Mohammed Tag-Adeen Fahd Ghalim Wael A Abbas Elsayed Ghoneem Khaled Ragab Mahmoud El-Ansary Shanil Kadir Sunil Amin keith siau Anna Wiechowska-Kozlowska Klaus Mönkemüller Dalia Abdelfatah Abeer Abdellatef Sundeep Lakhtakia Hussein Hassan Okasha Endoscopy Unit Department of GastroenterologyHospital of The Ministry of Interior and AdministrationSzczecin 01-218Poland Interventional Endoscopy Unit University Hospital Southampton NHS Foundation Trust3AX POUnited Kingdom Consultant Gastroenterologist AIG HospitalsHyderabad 500032India Department of Gastroenterology Prime Institute of Digestive SciencesRajkot 360001India Department of Gastroenterology Central Military Emergency University HospitalCarol Davila University of Medicine and PharmacyBucharest 010011Romania Division of Gastroenterology and Hepatology Department of Internal MedicineQena Faculty of MedicineSouth Valley UniversityQena 83511Egypt Department of Endoscopy Shefa Al-Orman HospitalLuxor 85951Egypt Interventional Endoscopy Unit Sainte Marie HospitalOSNY 95520France Department of Internal Medicine Gastroenterology UnitFaculty of MedicineAssuit UniversityAssuit 71511Egypt Department of Gastroenterology and Hepatology Faculty of MedicineMansoura UniversityMansoura 35511Egypt Department of Hepatology and Gastroenterology Theodor Bilharz Research InstituteGiza 12511Egypt Department of Hepatology&Gastroenterology Theodor Bilharz Research InstituteGiza 12511Egypt Department of Gastroenterology Liaquat National Hospital&Medical CollegeKarachi 75900Pakistan

BACKGROUND Solid pseudopapillary neoplasm(SPN)is an uncommon pathology of the pancreas with unpredictable malignant *** ultrasound(EUS)assessment plays a vital role in lesion characterization and confirmation of the tissue ***,there is a paucity of data regarding the imaging assessment of these *** To determine the characteristic EUS features of SPN and define its role in preoperative *** This was an international,multicenter,retrospective,observational study of prospective cohorts from 7 large hepatopancreaticobiliary *** cases with postoperative histology of SPN were included in the *** collected included clinical,biochemical,histological and EUS *** One hundred and six patients with the diagnosis of SPN were *** mean age was 26 years(range 9 to 70 years),with female predominance(89.6%).The most frequent clinical presentation was abdominal pain(80/106;75.5%).The mean diameter of the lesion was 53.7 mm(range 15 to 130 mm),with the slight predominant location in the head of the pancreas(44/106;41.5%).The majority of lesions presented with solid imaging features(59/106;55.7%)although 33.0%(35/106)had mixed solid/cystic characteristics and 11.3%(12/106)had cystic *** was observed in only 4(3.8%)*** pancreatic duct dilation was uncommon,evident in only 2 cases(1.9%),whilst common bile duct dilation was observed in 5(11.3%)*** patient demonstrated a double duct sign at *** and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable *** guided biopsy was performed using three different types of needles:Fine needle aspiration(67/106;63.2%),fine needle biopsy(37/106;34.9%),and Sonar Trucut(2/106;1.9%).The diagnosis was conclusive in 103(97.2%)***-seven patients were treated surgically(91.5%)and the post-surgical SPN diagnosis was confirmed in all *** the 2-year

关键词： Solid pseudopapillary neoplasm SPN Frantz tumor Endoscopic ultrasound features EUSguided biopsy Fine needle aspiration/biopsy

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