BACKGROUND: The complete removal of adenomatous polyps is important for reducing interval cancer after colonoscopy. AIMS: To identify factors affecting the completeness of colonoscopic polypectomies and to evaluate the experience level of fellows who achieve competence compared with that of experts. METHODS: Medical records of 1,860 patients who underwent at least one polypectomy for an adenomatous polyp at Seoul National University Hospital between March 2011 and February 2013 were retrospectively reviewed. A total of 3,469 adenomatous polyps were included. The lateral and deep margins of the resected polyps were evaluated to check the resection completeness. RESULTS: Of the 3,469 adenomatous polyps, 1,389 (40.0 %) were removed by two experts and 2,080 (60.0 %) were removed by seven fellows. In the expert-treated group, larger size [odds ratio (OR) 2.81 for ≥20 mm, 95 % confidence interval (CI) 1.64-4.84, P < 0.001] and right-sided location (OR 1.31, 95 % CI 1.05-1.63, P = 0.019) were associated with incomplete resection. In the fellow-treated group, not only polyp characteristics [right-sided location (OR 1.41, 95 % CI 1.18-1.69, P < 0.001)], but also the cumulative number of procedures was also related to resection completeness. After 300 polypectomies, the complete resection rate of the fellows was comparable to that of the experts. CONCLUSIONS: In the fellow-treated group, the level of procedure experience was closely associated with the polypectomy outcomes. Meticulous attention is critical to ensure the completeness of polypectomies performed by trainee endoscopists during the training program.
BACKGROUND: The complete removal of adenomatous polyps is important for reducing interval cancer after colonoscopy. AIMS: To identify factors affecting the completeness of colonoscopic polypectomies and to evaluate the experience level of fellows who achieve competence compared with that of experts. METHODS: Medical records of 1,860 patients who underwent at least one polypectomy for an adenomatous polyp at Seoul National University Hospital between March 2011 and February 2013 were retrospectively reviewed. A total of 3,469 adenomatous polyps were included. The lateral and deep margins of the resected polyps were evaluated to check the resection completeness. RESULTS: Of the 3,469 adenomatous polyps, 1,389 (40.0 %) were removed by two experts and 2,080 (60.0 %) were removed by seven fellows. In the expert-treated group, larger size [odds ratio (OR) 2.81 for ≥20 mm, 95 % confidence interval (CI) 1.64-4.84, P < 0.001] and right-sided location (OR 1.31, 95 % CI 1.05-1.63, P = 0.019) were associated with incomplete resection. In the fellow-treated group, not only polyp characteristics [right-sided location (OR 1.41, 95 % CI 1.18-1.69, P < 0.001)], but also the cumulative number of procedures was also related to resection completeness. After 300 polypectomies, the complete resection rate of the fellows was comparable to that of the experts. CONCLUSIONS: In the fellow-treated group, the level of procedure experience was closely associated with the polypectomy outcomes. Meticulous attention is critical to ensure the completeness of polypectomies performed by trainee endoscopists during the training program.
Authors: Mi Na Kim; Jung Mook Kang; Jong In Yang; Byoung Kwon Kim; Jong Pil Im; Sang Gyun Kim; Hyun Chae Jung; In Sung Song; Joo Sung Kim Journal: J Gastroenterol Hepatol Date: 2011-11 Impact factor: 4.029
Authors: Timothy A Woodward; Michael G Heckman; Patrick Cleveland; Silvio De Melo; Massimo Raimondo; Michael Wallace Journal: Am J Gastroenterol Date: 2012-05 Impact factor: 10.864
Authors: Jae Jun Park; Jae Hee Cheon; Ji Eun Kwon; Jae Kook Shin; Soung Min Jeon; Hyun Jung Bok; Jin Ha Lee; Chang Mo Moon; Sung Pil Hong; Tae Il Kim; Hoguen Kim; Won Ho Kim Journal: Gastrointest Endosc Date: 2011-12 Impact factor: 9.427
Authors: Douglas J Robertson; David A Lieberman; Sidney J Winawer; Dennis J Ahnen; John A Baron; Arthur Schatzkin; Amanda J Cross; Ann G Zauber; Timothy R Church; Peter Lance; E Robert Greenberg; María Elena Martínez Journal: Gut Date: 2013-06-21 Impact factor: 23.059
Authors: Bret J Spier; Mark Benson; Patrick R Pfau; Gregory Nelligan; Michael R Lucey; Eric A Gaumnitz Journal: Gastrointest Endosc Date: 2009-07-31 Impact factor: 9.427
Authors: Ji Yeon Seo; Seung Ho Choi; Jaeyoung Chun; Changhyun Lee; Ji Min Choi; Eun Hyo Jin; Sung Wook Hwang; Jong Pil Im; Sang Gyun Kim; Joo Sung Kim Journal: Intest Res Date: 2016-06-27