Document Detail


Learning curves for colonoscopy: a prospective evaluation of gastroenterology fellows at a single center.
MedLine Citation:
PMID:  20479910     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Colonoscopy training programs and the minimal experience with colonoscopy required to be considered technically competent are not well established. The aim of this study was to determine the colonoscopy learning curves and factors associated with this difficult procedure at a single center.
METHODS: A total of 3,243 colonoscopies were performed by 12 first-year gastroenterology fellows, and various clinical factors were assessed prospectively for 22 months. Acquisition of competence (success rate) was evaluated based on two objective criteria: (i) the adjusted completion rate (>90%) and (ii) cecal intubation time (<20 minutes).
RESULTS: The overall success rate in reaching the cecum in less than 20 minutes was 72.8%. The cecal intubation time was 9.34+/-4.13 minutes (mean+/-SD). Trainees' skill at performing cecal intubation in <20 minutes reached the requisite standard of competence after 200 procedures. Cecal intubation time decreased significantly from 11.3 to 9.4 minutes after 100 procedures and improved continuously thereafter. Female patients and advanced patient age (over 60 years) were associated with prolonged cecal intubation time (>20 minutes). Surgery of the uterus and ovaries was significantly correlated with delayed cecal intubation time, but not after sufficient colonoscopy experience.
CONCLUSIONS: The minimum number of procedures to reach technical competence was 200. The cecal intubation time was longer in female and older patients.
Authors:
Jae Il Chung; Nayoung Kim; Min Sik Um; Kyung Phil Kang; Donghun Lee; Jong Chun Na; Eun Sil Lee; Yeon Mu Chung; Ji Yeon Won; Kwang Ho Lee; Tek Man Nam; Jung Hun Lee; Hyun Chul Choi; Sang Hyub Lee; Young Soo Park; Jin Hyuk Hwang; Jin-Wook Kim; Sook-Hyang Jeong; Dong Ho Lee
Publication Detail:
Type:  Journal Article     Date:  2010-03-25
Journal Detail:
Title:  Gut and liver     Volume:  4     ISSN:  2005-1212     ISO Abbreviation:  Gut Liver     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-18     Completed Date:  2011-07-14     Revised Date:  2013-11-13    
Medline Journal Info:
Nlm Unique ID:  101316452     Medline TA:  Gut Liver     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  31-5     Citation Subset:  -    
Affiliation:
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
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