| Title |
Learning curve and clinical outcome of gastric endoscopic submucosal dissection performed by trainee operators
|
|---|---|
| Published in |
Surgical Endoscopy, December 2016
|
| DOI | 10.1007/s00464-016-5393-9 |
| Pubmed ID | |
| 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 |
| 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 endoscopists. Between 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. Long-term outcomes were also analyzed. The 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 5.7 ± 3.2 min/cm(2) in Phase I, 4.7 ± 2.7 min/cm(2) in Phase II, and 4.3 ± 2.2 min/cm(2) in Phase III. The resection speed was significantly faster in Phase II than in Phase I (p = 0.019). The rate of self-completion 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 follow-up of 38 months. For the trainees, 30 cases were required to attain a higher technical level of competence in gastric ESD. After the learning curve phase, trainee operators could be expected to complete the procedure successfully with favorable long-term outcomes. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Science communicators (journalists, bloggers, editors) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 19 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 19 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Librarian | 2 | 11% |
| Student > Doctoral Student | 2 | 11% |
| Researcher | 2 | 11% |
| Other | 1 | 5% |
| Student > Ph. D. Student | 1 | 5% |
| Other | 3 | 16% |
| Unknown | 8 | 42% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 7 | 37% |
| Nursing and Health Professions | 1 | 5% |
| Environmental Science | 1 | 5% |
| Agricultural and Biological Sciences | 1 | 5% |
| Engineering | 1 | 5% |
| Other | 0 | 0% |
| Unknown | 8 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 January 2017.
All research outputs
#13,819,626
of 22,925,760 outputs
Outputs from Surgical Endoscopy
#3,018
of 6,076 outputs
Outputs of similar age
#218,814
of 421,458 outputs
Outputs of similar age from Surgical Endoscopy
#46
of 87 outputs
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