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대장직장 종양에 대한 내시경 점막하 절제술의 연대순 임상 결과와 학습 곡선

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Author(s)
이상민김은수박경식조광범김동춘강유진이유진이정민최은성최재혁이호영
Keimyung Author(s)
Kim, Eun SooPark, Kyung SikCho, Kwang BumLee, Yoo Jin
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Journal of Gastroenterology
Issued Date
2014
Volume
64
Issue
4
Keyword
Learning curveColonEndoscopyDissection
Abstract
Background/Aims: Endoscopic submucosal dissection (ESD) is an effective procedure for en-bloc curative resection of the colorectal tumor. As it requires high technical skills and experience in therapeutic endoscopy, it is important to understand learning curve of ESD technique. The aim of this study was to retrospectively describe the clinical results of ESD and to evaluate learning curve for the ESD of colorectal tumors.
Methods: A total of 90 patients with 90 colorectal neoplasms, who had undergone ESD at a tertiary referral hospital from July 2009 to December 2012, were enrolled. The ESD was performed by a single endoscopist. All ESD cases were divided into three periods: first, cases 1-30; second, cases 31-60; and third, cases 61-90. Results: The en-bloc resection rates in third period (100%) was significantly higher than that of the first (93.3%) and second period (80%) (p=0.025). The perforation rate in third period (0%) also significantly decreased compared with that of the first (13.3%) and second period (20%) (p=0.032). To calibrate the difference of tumor size among periods, proficiency was calculated, as the procedure time per specimen area (min/cm2). The proficiency in third period (4.3) was significantly shorter than that of the first (16.8) and second period (10.2) (p=0.004). Conclusions: The learning curve of colorectal ESD in our study shows that at least 60 cases of ESD have to be conducted to acquire sufficient skill of degree without perforation.
Alternative Title
Chronological Outcomes and Learning Curve of Endoscopic Submucosal Dissection for Colorectal Tumors
Keimyung Author(s)(Kor)
김은수
박경식
조광범
이유진
Publisher
School of Medicine
Citation
이상민 et al. (2014). 대장직장 종양에 대한 내시경 점막하 절제술의 연대순 임상 결과와 학습 곡선. Korean Journal of Gastroenterology, 64(4), 198–205. doi: 10.4166/kjg.2014.64.4.198
Type
Article
ISSN
1598-9992
DOI
10.4166/kjg.2014.64.4.198
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/36081
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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