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Small caliber overtube-assisted colonoscopy

World Journal of Gastroenterology 2007年第44期13卷 5933-5937页

作者： Shai Friedland roy M soetikno Stanford University School of Medicine and VA Palo Alto Health Care System United States

AIM: To combine the benefits of a new thin flexible scope with elimination of excessive looping through the use of an overtube. METHODS: Three separate retrospective series. Series 1: 25 consecutive male patients undergoing unsedated colonoscopy using the new device at a Veteran's hospital in the United States. Series 2: 75 male patients undergoing routine colonoscopy using an adult colonoscope, pediatric colonoscope, or the new device. Series 3: 35 patients who had incomplete colonoscopies using standard instruments. RESULTS: Complete colonoscopy was achieved in all 25 patients in the unsedated series with a median cecal intubation time of 6 min and a median maximal pain score of 3 on a 0-10 scale. In the 75 routine cases, there was significantly less pain with the thin scope compared to standard adult and pediatric colonoscopes. Of the 35 patients in the previously incomplete colonoscopy series, 33 were completed with the new system. CONCLUSION: Small caliber overtube-assisted colonoscopy is less painful than colonoscopy with standard adult and pediatric colonoscopes. Male patients could undergo unsedated colonoscopy with the new system with relatively little pain. The new device is also useful for most patients in whom colonoscopy cannot be completed with standard instruments.

关键词： Colonoscopy Endoscopy Colon Cancer Colon cancer screening

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Colonoscopic polypectomy in anticoagulated patients

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World Journal of Gastroenterology 2009年第16期15卷 1973-1976页

作者： Shai Friedland Daniel Sedehi roy soetikno Division of Gastroenterology GI-111VA Palo Alto and Stanford University

AIM:To review our experience performing polypectomy in anticoagulated patients without interruption of ***: Retrospective chart review at the Veterans Affairs Palo Alto Health Care System. Two hundred and twenty five polypectomies were performed in 123 patients. Patients followed a standardized protocol that included stopping warfarin for 36 h to avoid supratherapeutic anticoagulation from the bowel preparation. Patients with lesions larger than 1 cm were generally rescheduled for polypectomy off warfarin. Endoscopic clips were routinely applied prophylactically. RESULTS: One patient (0.8%, 95% CI: 0.1%-4.5%) developed major post-polypectomy bleeding that required transfusion. Two others (1.6%, 95% CI: 0.5%-5.7%) had self-limited hematochezia at home and did not seek medical attention. The average polyp size was 5.1 ± 2.2 mm. CONCLUSION: Polypectomy can be performed in therapeutically anticoagulated patients with lesions up to 1 cm in size with an acceptable bleeding rate.

关键词： Colon cancer Colonic polyps Colonoscopy Early detection of cancer Endoscopy Hemorrhage Thrombosis Warfarin

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Simulation-based mastery learning in gastrointestinal endoscopy training

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World Journal of Gastrointestinal Endoscopy 2022年第9期14卷 512-523页

作者： Hasan Maulahela Nagita Gianty Annisa Tiffany Konstantin Ari Fahrial Syam roy soetikno Department of Internal Medicine Gastroenterology DivisionFaculty of Medicine University of Indonesia-Cipto Mangunkusumo General Central National HospitalJakarta 10430Indonesia Tiffany Konstantin Faculty of MedicineUniversity of IndonesiaJakarta 10430Indonesia

Simulation-based mastery learning(SBML)is an emerging form of competencybased training that has been proposed as the next standard method for procedural task training,including that in gastr-ointestinal *** basic gastrointestinal endoscopy training relies on the number of procedures performed,and it has been criticized for its lack of objective standards that result in variable skills among trainees and its association with patient safety ***,incorporating simulators into a competency-based curriculum seems ideal for gastrointestinal endoscopy *** curriculum for SBML in gastrointestinal endoscopy is currently being developed and has promising potential to translate into the clinical *** the present apprenticeship model of“see one,do one,teach one,”SBML integrates a competency-based curriculum with specific learning objectives alongside simulation-based *** allows trainees to practice essential skills repeatedly,receive feedback from experts,and gradually develop their abilities to achieve ***,trainees and trainers need to understand the learning targets of the program so that trainees can focus their learning on the necessary skills and trainers can provide structured feedback based on the expected *** addition to learning targets,an assessment plan is essential to provide trainees with future directions for their improvement and ensure patient safety by issuing a passing ***,the SBML program should be planned and managed by a specific team and conducted within a developed and tested *** review discusses the current state of gastr-ointestinal endoscopy training and the role of SBML in that field.

关键词： Simulation training Education Endoscopy Mastery learning Competency-based education Curriculum

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