Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Endoscopic mucosal resection (EMR) is the standard of care for the complete removal of large (≥ 10 mm) nonpedunculated colorectal polyps (LNPCPs). Increased detection of LNPCPs owing to screening colonoscopy, plus high observed rates of incomplete resection and need for surgery call for a standardiz...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:ENDOSCOPY 2023-07, Vol.55 (7), p.645-679
Hauptverfasser: Tate, David J, Argenziano, Maria Eva, Anderson, John, Bhandari, Pradeep, Boskoski, Ivo, Bugajski, Marek, Desomer, Lobke, Heitman, Steven J, Kashida, Hiroshi, Kriazhov, Vladimir, Lee, Ralph R.T, Lyutakov, Ivan, Pimentel-Nunes, Pedro, Rivero-Sanchez, Liseth, Thomas-Gibson, Siwan, Thorlacius, Henrik, Bourke, Michael J, Tham, Tony C, Bisschops, Raf
Format: Artikel
Sprache:eng
Online-Zugang:Volltext bestellen
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 679
container_issue 7
container_start_page 645
container_title ENDOSCOPY
container_volume 55
creator Tate, David J
Argenziano, Maria Eva
Anderson, John
Bhandari, Pradeep
Boskoski, Ivo
Bugajski, Marek
Desomer, Lobke
Heitman, Steven J
Kashida, Hiroshi
Kriazhov, Vladimir
Lee, Ralph R.T
Lyutakov, Ivan
Pimentel-Nunes, Pedro
Rivero-Sanchez, Liseth
Thomas-Gibson, Siwan
Thorlacius, Henrik
Bourke, Michael J
Tham, Tony C
Bisschops, Raf
description Endoscopic mucosal resection (EMR) is the standard of care for the complete removal of large (≥ 10 mm) nonpedunculated colorectal polyps (LNPCPs). Increased detection of LNPCPs owing to screening colonoscopy, plus high observed rates of incomplete resection and need for surgery call for a standardized approach to training in EMR. 1 : Trainees in EMR should have achieved basic competence in diagnostic colonoscopy,
format Article
fullrecord <record><control><sourceid>kuleuven_FZOIL</sourceid><recordid>TN_cdi_kuleuven_dspace_20_500_12942_733002</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>20_500_12942_733002</sourcerecordid><originalsourceid>FETCH-kuleuven_dspace_20_500_12942_7330023</originalsourceid><addsrcrecordid>eNqVj81KA0EQhOegYPx5hz6qEJnMGoNewxqPwnrwNgyTXh2d7V6me8S8hM9sInkAcyqK-qqgjszE2lkzXbi71xNzKvKxs9bOJ-ZnWUtJseY6QM8FtIREid4gESCtWSKPKcJQI0vIUFAwamLa5fqOEDkzPUBbC48YCDqOCXUD3MMqiBZOpCiaaFtu93sbuGy7VXsFzyzpb6zToDgg6bk57kMWvNjrmbl-bF-WT9PPmrF-Ifm1jCGid9bPrfUzd3_r_KLZnnHNgfDNv2Gv39r8AtUzZtI</addsrcrecordid><sourcetype>Institutional Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement</title><source>Lirias (KU Leuven Association)</source><creator>Tate, David J ; Argenziano, Maria Eva ; Anderson, John ; Bhandari, Pradeep ; Boskoski, Ivo ; Bugajski, Marek ; Desomer, Lobke ; Heitman, Steven J ; Kashida, Hiroshi ; Kriazhov, Vladimir ; Lee, Ralph R.T ; Lyutakov, Ivan ; Pimentel-Nunes, Pedro ; Rivero-Sanchez, Liseth ; Thomas-Gibson, Siwan ; Thorlacius, Henrik ; Bourke, Michael J ; Tham, Tony C ; Bisschops, Raf</creator><creatorcontrib>Tate, David J ; Argenziano, Maria Eva ; Anderson, John ; Bhandari, Pradeep ; Boskoski, Ivo ; Bugajski, Marek ; Desomer, Lobke ; Heitman, Steven J ; Kashida, Hiroshi ; Kriazhov, Vladimir ; Lee, Ralph R.T ; Lyutakov, Ivan ; Pimentel-Nunes, Pedro ; Rivero-Sanchez, Liseth ; Thomas-Gibson, Siwan ; Thorlacius, Henrik ; Bourke, Michael J ; Tham, Tony C ; Bisschops, Raf</creatorcontrib><description>Endoscopic mucosal resection (EMR) is the standard of care for the complete removal of large (≥ 10 mm) nonpedunculated colorectal polyps (LNPCPs). Increased detection of LNPCPs owing to screening colonoscopy, plus high observed rates of incomplete resection and need for surgery call for a standardized approach to training in EMR. 1 : Trainees in EMR should have achieved basic competence in diagnostic colonoscopy, &lt; 10-mm polypectomy, pedunculated polypectomy, and common methods of gastrointestinal endoscopic hemostasis. The role of formal training courses is emphasized. Training may then commence in vivo under the direct supervision of a trainer. 2 : Endoscopy units training endoscopists in EMR should have specific processes in place to support and facilitate training. 3: A trained EMR practitioner should have mastered theoretical knowledge including how to assess an LNPCP for risk of submucosal invasion, how to interpret the potential difficulty of a particular EMR procedure, how to decide whether to remove a particular LNPCP en bloc or piecemeal, whether the risks of electrosurgical energy can be avoided for a particular LNPCP, the different devices required for EMR, management of adverse events, and interpretation of reports provided by histopathologists. 4: Trained EMR practitioners should be familiar with the patient consent process for EMR. 5: The development of endoscopic non-technical skills (ENTS) and team interaction are important for trainees in EMR. 6: Differences in recommended technique exist between EMR performed with and without electrosurgical energy. Common to both is a standardized technique based upon dynamic injection, controlled and precise snare placement, safety checks prior to the application of tissue transection (cold snare) or electrosurgical energy (hot snare), and interpretation of the post-EMR resection defect. 7: A trained EMR practitioner must be able to manage adverse events associated with EMR including intraprocedural bleeding and perforation, and post-procedural bleeding. Delayed perforation should be avoided by correct interpretation of the post-EMR defect and treatment of deep mural injury. 8: A trained EMR practitioner must be able to communicate EMR procedural findings to patients and provide them with a plan in case of adverse events after discharge and a follow-up plan. 9: A trained EMR practitioner must be able to detect and interrogate a post-endoscopic resection scar for residual or recurrent adenoma and apply treatment if necessary. 10: Prior to independent practice, a minimum of 30 EMR procedures should be performed, culminating in a trainer-guided assessment of competency using a validated assessment tool, taking account of procedural difficulty (e. g. using the SMSA polyp score). 11: Trained practitioners should log their key performance indicators (KPIs) of polypectomy during independent practice. A guide for target KPIs is provided in this document.</description><identifier>ISSN: 0013-726X</identifier><language>eng</language><publisher>GEORG THIEME VERLAG KG</publisher><ispartof>ENDOSCOPY, 2023-07, Vol.55 (7), p.645-679</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,780,27858</link.rule.ids><linktorsrc>$$Uhttps://lirias.kuleuven.be/handle/20.500.12942/733002$$EView_record_in_KU_Leuven_Association$$FView_record_in_$$GKU_Leuven_Association</linktorsrc></links><search><creatorcontrib>Tate, David J</creatorcontrib><creatorcontrib>Argenziano, Maria Eva</creatorcontrib><creatorcontrib>Anderson, John</creatorcontrib><creatorcontrib>Bhandari, Pradeep</creatorcontrib><creatorcontrib>Boskoski, Ivo</creatorcontrib><creatorcontrib>Bugajski, Marek</creatorcontrib><creatorcontrib>Desomer, Lobke</creatorcontrib><creatorcontrib>Heitman, Steven J</creatorcontrib><creatorcontrib>Kashida, Hiroshi</creatorcontrib><creatorcontrib>Kriazhov, Vladimir</creatorcontrib><creatorcontrib>Lee, Ralph R.T</creatorcontrib><creatorcontrib>Lyutakov, Ivan</creatorcontrib><creatorcontrib>Pimentel-Nunes, Pedro</creatorcontrib><creatorcontrib>Rivero-Sanchez, Liseth</creatorcontrib><creatorcontrib>Thomas-Gibson, Siwan</creatorcontrib><creatorcontrib>Thorlacius, Henrik</creatorcontrib><creatorcontrib>Bourke, Michael J</creatorcontrib><creatorcontrib>Tham, Tony C</creatorcontrib><creatorcontrib>Bisschops, Raf</creatorcontrib><title>Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement</title><title>ENDOSCOPY</title><description>Endoscopic mucosal resection (EMR) is the standard of care for the complete removal of large (≥ 10 mm) nonpedunculated colorectal polyps (LNPCPs). Increased detection of LNPCPs owing to screening colonoscopy, plus high observed rates of incomplete resection and need for surgery call for a standardized approach to training in EMR. 1 : Trainees in EMR should have achieved basic competence in diagnostic colonoscopy, &lt; 10-mm polypectomy, pedunculated polypectomy, and common methods of gastrointestinal endoscopic hemostasis. The role of formal training courses is emphasized. Training may then commence in vivo under the direct supervision of a trainer. 2 : Endoscopy units training endoscopists in EMR should have specific processes in place to support and facilitate training. 3: A trained EMR practitioner should have mastered theoretical knowledge including how to assess an LNPCP for risk of submucosal invasion, how to interpret the potential difficulty of a particular EMR procedure, how to decide whether to remove a particular LNPCP en bloc or piecemeal, whether the risks of electrosurgical energy can be avoided for a particular LNPCP, the different devices required for EMR, management of adverse events, and interpretation of reports provided by histopathologists. 4: Trained EMR practitioners should be familiar with the patient consent process for EMR. 5: The development of endoscopic non-technical skills (ENTS) and team interaction are important for trainees in EMR. 6: Differences in recommended technique exist between EMR performed with and without electrosurgical energy. Common to both is a standardized technique based upon dynamic injection, controlled and precise snare placement, safety checks prior to the application of tissue transection (cold snare) or electrosurgical energy (hot snare), and interpretation of the post-EMR resection defect. 7: A trained EMR practitioner must be able to manage adverse events associated with EMR including intraprocedural bleeding and perforation, and post-procedural bleeding. Delayed perforation should be avoided by correct interpretation of the post-EMR defect and treatment of deep mural injury. 8: A trained EMR practitioner must be able to communicate EMR procedural findings to patients and provide them with a plan in case of adverse events after discharge and a follow-up plan. 9: A trained EMR practitioner must be able to detect and interrogate a post-endoscopic resection scar for residual or recurrent adenoma and apply treatment if necessary. 10: Prior to independent practice, a minimum of 30 EMR procedures should be performed, culminating in a trainer-guided assessment of competency using a validated assessment tool, taking account of procedural difficulty (e. g. using the SMSA polyp score). 11: Trained practitioners should log their key performance indicators (KPIs) of polypectomy during independent practice. A guide for target KPIs is provided in this document.</description><issn>0013-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>FZOIL</sourceid><recordid>eNqVj81KA0EQhOegYPx5hz6qEJnMGoNewxqPwnrwNgyTXh2d7V6me8S8hM9sInkAcyqK-qqgjszE2lkzXbi71xNzKvKxs9bOJ-ZnWUtJseY6QM8FtIREid4gESCtWSKPKcJQI0vIUFAwamLa5fqOEDkzPUBbC48YCDqOCXUD3MMqiBZOpCiaaFtu93sbuGy7VXsFzyzpb6zToDgg6bk57kMWvNjrmbl-bF-WT9PPmrF-Ifm1jCGid9bPrfUzd3_r_KLZnnHNgfDNv2Gv39r8AtUzZtI</recordid><startdate>202307</startdate><enddate>202307</enddate><creator>Tate, David J</creator><creator>Argenziano, Maria Eva</creator><creator>Anderson, John</creator><creator>Bhandari, Pradeep</creator><creator>Boskoski, Ivo</creator><creator>Bugajski, Marek</creator><creator>Desomer, Lobke</creator><creator>Heitman, Steven J</creator><creator>Kashida, Hiroshi</creator><creator>Kriazhov, Vladimir</creator><creator>Lee, Ralph R.T</creator><creator>Lyutakov, Ivan</creator><creator>Pimentel-Nunes, Pedro</creator><creator>Rivero-Sanchez, Liseth</creator><creator>Thomas-Gibson, Siwan</creator><creator>Thorlacius, Henrik</creator><creator>Bourke, Michael J</creator><creator>Tham, Tony C</creator><creator>Bisschops, Raf</creator><general>GEORG THIEME VERLAG KG</general><scope>FZOIL</scope></search><sort><creationdate>202307</creationdate><title>Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement</title><author>Tate, David J ; Argenziano, Maria Eva ; Anderson, John ; Bhandari, Pradeep ; Boskoski, Ivo ; Bugajski, Marek ; Desomer, Lobke ; Heitman, Steven J ; Kashida, Hiroshi ; Kriazhov, Vladimir ; Lee, Ralph R.T ; Lyutakov, Ivan ; Pimentel-Nunes, Pedro ; Rivero-Sanchez, Liseth ; Thomas-Gibson, Siwan ; Thorlacius, Henrik ; Bourke, Michael J ; Tham, Tony C ; Bisschops, Raf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kuleuven_dspace_20_500_12942_7330023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tate, David J</creatorcontrib><creatorcontrib>Argenziano, Maria Eva</creatorcontrib><creatorcontrib>Anderson, John</creatorcontrib><creatorcontrib>Bhandari, Pradeep</creatorcontrib><creatorcontrib>Boskoski, Ivo</creatorcontrib><creatorcontrib>Bugajski, Marek</creatorcontrib><creatorcontrib>Desomer, Lobke</creatorcontrib><creatorcontrib>Heitman, Steven J</creatorcontrib><creatorcontrib>Kashida, Hiroshi</creatorcontrib><creatorcontrib>Kriazhov, Vladimir</creatorcontrib><creatorcontrib>Lee, Ralph R.T</creatorcontrib><creatorcontrib>Lyutakov, Ivan</creatorcontrib><creatorcontrib>Pimentel-Nunes, Pedro</creatorcontrib><creatorcontrib>Rivero-Sanchez, Liseth</creatorcontrib><creatorcontrib>Thomas-Gibson, Siwan</creatorcontrib><creatorcontrib>Thorlacius, Henrik</creatorcontrib><creatorcontrib>Bourke, Michael J</creatorcontrib><creatorcontrib>Tham, Tony C</creatorcontrib><creatorcontrib>Bisschops, Raf</creatorcontrib><collection>Lirias (KU Leuven Association)</collection><jtitle>ENDOSCOPY</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Tate, David J</au><au>Argenziano, Maria Eva</au><au>Anderson, John</au><au>Bhandari, Pradeep</au><au>Boskoski, Ivo</au><au>Bugajski, Marek</au><au>Desomer, Lobke</au><au>Heitman, Steven J</au><au>Kashida, Hiroshi</au><au>Kriazhov, Vladimir</au><au>Lee, Ralph R.T</au><au>Lyutakov, Ivan</au><au>Pimentel-Nunes, Pedro</au><au>Rivero-Sanchez, Liseth</au><au>Thomas-Gibson, Siwan</au><au>Thorlacius, Henrik</au><au>Bourke, Michael J</au><au>Tham, Tony C</au><au>Bisschops, Raf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement</atitle><jtitle>ENDOSCOPY</jtitle><date>2023-07</date><risdate>2023</risdate><volume>55</volume><issue>7</issue><spage>645</spage><epage>679</epage><pages>645-679</pages><issn>0013-726X</issn><abstract>Endoscopic mucosal resection (EMR) is the standard of care for the complete removal of large (≥ 10 mm) nonpedunculated colorectal polyps (LNPCPs). Increased detection of LNPCPs owing to screening colonoscopy, plus high observed rates of incomplete resection and need for surgery call for a standardized approach to training in EMR. 1 : Trainees in EMR should have achieved basic competence in diagnostic colonoscopy, &lt; 10-mm polypectomy, pedunculated polypectomy, and common methods of gastrointestinal endoscopic hemostasis. The role of formal training courses is emphasized. Training may then commence in vivo under the direct supervision of a trainer. 2 : Endoscopy units training endoscopists in EMR should have specific processes in place to support and facilitate training. 3: A trained EMR practitioner should have mastered theoretical knowledge including how to assess an LNPCP for risk of submucosal invasion, how to interpret the potential difficulty of a particular EMR procedure, how to decide whether to remove a particular LNPCP en bloc or piecemeal, whether the risks of electrosurgical energy can be avoided for a particular LNPCP, the different devices required for EMR, management of adverse events, and interpretation of reports provided by histopathologists. 4: Trained EMR practitioners should be familiar with the patient consent process for EMR. 5: The development of endoscopic non-technical skills (ENTS) and team interaction are important for trainees in EMR. 6: Differences in recommended technique exist between EMR performed with and without electrosurgical energy. Common to both is a standardized technique based upon dynamic injection, controlled and precise snare placement, safety checks prior to the application of tissue transection (cold snare) or electrosurgical energy (hot snare), and interpretation of the post-EMR resection defect. 7: A trained EMR practitioner must be able to manage adverse events associated with EMR including intraprocedural bleeding and perforation, and post-procedural bleeding. Delayed perforation should be avoided by correct interpretation of the post-EMR defect and treatment of deep mural injury. 8: A trained EMR practitioner must be able to communicate EMR procedural findings to patients and provide them with a plan in case of adverse events after discharge and a follow-up plan. 9: A trained EMR practitioner must be able to detect and interrogate a post-endoscopic resection scar for residual or recurrent adenoma and apply treatment if necessary. 10: Prior to independent practice, a minimum of 30 EMR procedures should be performed, culminating in a trainer-guided assessment of competency using a validated assessment tool, taking account of procedural difficulty (e. g. using the SMSA polyp score). 11: Trained practitioners should log their key performance indicators (KPIs) of polypectomy during independent practice. A guide for target KPIs is provided in this document.</abstract><pub>GEORG THIEME VERLAG KG</pub></addata></record>
fulltext fulltext_linktorsrc
identifier ISSN: 0013-726X
ispartof ENDOSCOPY, 2023-07, Vol.55 (7), p.645-679
issn 0013-726X
language eng
recordid cdi_kuleuven_dspace_20_500_12942_733002
source Lirias (KU Leuven Association)
title Curriculum for training in endoscopic mucosal resection in the colon: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T13%3A08%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-kuleuven_FZOIL&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Curriculum%20for%20training%20in%20endoscopic%20mucosal%20resection%20in%20the%20colon:%20European%20Society%20of%20Gastrointestinal%20Endoscopy%20(ESGE)%20Position%20Statement&rft.jtitle=ENDOSCOPY&rft.au=Tate,%20David%20J&rft.date=2023-07&rft.volume=55&rft.issue=7&rft.spage=645&rft.epage=679&rft.pages=645-679&rft.issn=0013-726X&rft_id=info:doi/&rft_dat=%3Ckuleuven_FZOIL%3E20_500_12942_733002%3C/kuleuven_FZOIL%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rfr_iscdi=true