Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection?
Background/Aims The learning curve is essential in endoscopic submucosal dissection (ESD) training to improve outcomes and reduce the risk of procedure-related complications. We compared the outcomes of gastric ESD in live pigs performed by inexperienced endoscopists with or without ex vivo training...
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Korean College of Helicobacter and Upper Gastrointestinal Research
2021-06-01
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| Series: | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
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| Online Access: | http://www.helicojournal.org/upload/pdf/kjhugr-2020-0064.pdf |
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| author | Gyu Young Pih Jung Su Lee Ji Yong Ahn Do Hoon Kim Hee Kyong Na Jeong Hoon Lee Kee Wook Jung Kee Don Choi Ho June Song Gin Hyug Lee Hwoon-Yong Jung |
| author_facet | Gyu Young Pih Jung Su Lee Ji Yong Ahn Do Hoon Kim Hee Kyong Na Jeong Hoon Lee Kee Wook Jung Kee Don Choi Ho June Song Gin Hyug Lee Hwoon-Yong Jung |
| author_sort | Gyu Young Pih |
| collection | DOAJ |
| description | Background/Aims The learning curve is essential in endoscopic submucosal dissection (ESD) training to improve outcomes and reduce the risk of procedure-related complications. We compared the outcomes of gastric ESD in live pigs performed by inexperienced endoscopists with or without ex vivo training. Materials and Methods At the Olympus Medical Training and Education Center, nine endoscopists inexperienced in ESD were randomly divided into two groups (group A: ex vivo training followed by in vivo training; group B: in vivo training only), and they performed gastric ESDs. Results A total of 18 ESDs were performed. The en bloc resection rate was 88.9% (16/18), and the complete resection rate was 94.4% (17/18). The median specimen size was 2.5 cm in group A and 2.1 cm in group B (P=0.227). There was no significant difference in the procedure time between the two groups, except for the marking time (0′58″ vs. 2′58″, P=0.027). However, group A took a shorter time in dissecting the same area than group B (109 vs. 246 sec/cm2, P=0.083). Complication rates were not significantly different between both groups. Conclusions The procedure time during in vivo ESD training in pigs may be shortened by prior ex vivo training. However, the ex vivo model presented poor air inflation, unstable fixation, and excessive mucosal hardness for cutting. An advanced simulator or sufficient ex vivo training may be effective in training for the ESD procedure. |
| format | Article |
| id | doaj-art-1925a67f2dae4614991d6654fbcc40b4 |
| institution | Kabale University |
| issn | 1738-3331 |
| language | English |
| publishDate | 2021-06-01 |
| publisher | Korean College of Helicobacter and Upper Gastrointestinal Research |
| record_format | Article |
| series | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| spelling | doaj-art-1925a67f2dae4614991d6654fbcc40b42025-08-20T03:33:18ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312021-06-0121214415110.7704/kjhugr.2020.0064674Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection?Gyu Young Pih0Jung Su Lee1Ji Yong Ahn2Do Hoon Kim3Hee Kyong Na4Jeong Hoon Lee5Kee Wook Jung6Kee Don Choi7Ho June Song8Gin Hyug Lee9Hwoon-Yong Jung10Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground/Aims The learning curve is essential in endoscopic submucosal dissection (ESD) training to improve outcomes and reduce the risk of procedure-related complications. We compared the outcomes of gastric ESD in live pigs performed by inexperienced endoscopists with or without ex vivo training. Materials and Methods At the Olympus Medical Training and Education Center, nine endoscopists inexperienced in ESD were randomly divided into two groups (group A: ex vivo training followed by in vivo training; group B: in vivo training only), and they performed gastric ESDs. Results A total of 18 ESDs were performed. The en bloc resection rate was 88.9% (16/18), and the complete resection rate was 94.4% (17/18). The median specimen size was 2.5 cm in group A and 2.1 cm in group B (P=0.227). There was no significant difference in the procedure time between the two groups, except for the marking time (0′58″ vs. 2′58″, P=0.027). However, group A took a shorter time in dissecting the same area than group B (109 vs. 246 sec/cm2, P=0.083). Complication rates were not significantly different between both groups. Conclusions The procedure time during in vivo ESD training in pigs may be shortened by prior ex vivo training. However, the ex vivo model presented poor air inflation, unstable fixation, and excessive mucosal hardness for cutting. An advanced simulator or sufficient ex vivo training may be effective in training for the ESD procedure.http://www.helicojournal.org/upload/pdf/kjhugr-2020-0064.pdfeducationendoscopic submucosal dissectionstomach |
| spellingShingle | Gyu Young Pih Jung Su Lee Ji Yong Ahn Do Hoon Kim Hee Kyong Na Jeong Hoon Lee Kee Wook Jung Kee Don Choi Ho June Song Gin Hyug Lee Hwoon-Yong Jung Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection? The Korean Journal of Helicobacter and Upper Gastrointestinal Research education endoscopic submucosal dissection stomach |
| title | Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection? |
| title_full | Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection? |
| title_fullStr | Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection? |
| title_full_unstemmed | Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection? |
| title_short | Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection? |
| title_sort | is ex vivo training before in vivo training effective in learning gastric endoscopic submucosal dissection |
| topic | education endoscopic submucosal dissection stomach |
| url | http://www.helicojournal.org/upload/pdf/kjhugr-2020-0064.pdf |
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