Complete Resection of Colorectal Adenomas: What Are the Important Factors in Fellow Training?
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. M...
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| Veröffentlicht in: | Digestive diseases and sciences 2015-06, Vol.60 (6), p.1579-1588 |
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| creator | Choi, Ji Min Lee, Changhyun Park, Jeong Hwan Oh, Hyeon Jeong Hwang, Sung Wook Chun, Jaeyoung Koh, Seong-Joon Im, Jong Pil Kim, Ji Won Kim, Joo Sung Kim, Byeong Gwan Lee, Kook Lae |
| description | 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
|
| doi_str_mv | 10.1007/s10620-014-3500-0 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1942219239</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A712943901</galeid><sourcerecordid>A712943901</sourcerecordid><originalsourceid>FETCH-LOGICAL-c608t-7c626272a9b1f8d0b4e31dc7c4523f2afd8df615d8f68d1676b040c8eb7ea3383</originalsourceid><addsrcrecordid>eNqFkU-LFDEQxYMo7uzqB_AiAS9eeq1KupO0FxkGZ11YEGTFk4R0Oj3bS3cyJhkWv71pZv2LIjmkKvm9RxWPkGcI5wggXyUEwaACrCveQCkekBU2klesEeohWQGKUiOKE3Ka0i0AtBLFY3LCmqYGUHJFPm_CvJ9cdvSDS87mMXgaBroJU4ilNRNd986H2aTX9NONyXQdHc03jl7O-xCz8Zlujc0hJjp6unXTFO7odTSjH_3uzRPyaDBTck_v7zPycfv2evOuunp_cblZX1VWgMqVtIIJJplpOxxUD13tOPZW2rphfGBm6FU_CGx6NQjVo5Cigxqscp10hnPFz8jLo-8-hi8Hl7Kex2TLMMa7cEga25oxbBlv_48KJUBCUy_oiz_Q23CIviyyUA3ytgb1k9qZyenRDyFHYxdTvZbI2pq3gIU6_wtVTu_m0QbvhrG8_ybAo8DGkFJ0g97HcTbxq0bQS_r6mL4u6eslfQ1F8_x-4EM3u_6H4nvcBWBHIJUvv3Pxl43-6foNnsm2aA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1685139408</pqid></control><display><type>article</type><title>Complete Resection of Colorectal Adenomas: What Are the Important Factors in Fellow Training?</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Choi, Ji Min ; Lee, Changhyun ; Park, Jeong Hwan ; Oh, Hyeon Jeong ; Hwang, Sung Wook ; Chun, Jaeyoung ; Koh, Seong-Joon ; Im, Jong Pil ; Kim, Ji Won ; Kim, Joo Sung ; Kim, Byeong Gwan ; Lee, Kook Lae</creator><creatorcontrib>Choi, Ji Min ; Lee, Changhyun ; Park, Jeong Hwan ; Oh, Hyeon Jeong ; Hwang, Sung Wook ; Chun, Jaeyoung ; Koh, Seong-Joon ; Im, Jong Pil ; Kim, Ji Won ; Kim, Joo Sung ; Kim, Byeong Gwan ; Lee, Kook Lae</creatorcontrib><description>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.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-014-3500-0</identifier><identifier>PMID: 25540087</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adenomatous Polyps - pathology ; Adenomatous Polyps - surgery ; Adult ; Aged ; Aged, 80 and over ; Biochemistry ; Clinical Competence ; Colonoscopy ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - surgery ; Colorectal Surgery - education ; Comparative analysis ; Education, Medical, Graduate ; Fellowships and Scholarships ; Female ; Gastroenterology ; Hepatology ; Humans ; Male ; Medical colleges ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Original Article ; Pneumoviridae ; Retrospective Studies ; Seoul ; Surgery ; Transplant Surgery ; Treatment Outcome</subject><ispartof>Digestive diseases and sciences, 2015-06, Vol.60 (6), p.1579-1588</ispartof><rights>Springer Science+Business Media New York 2014</rights><rights>COPYRIGHT 2015 Springer</rights><rights>Springer Science+Business Media New York 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c608t-7c626272a9b1f8d0b4e31dc7c4523f2afd8df615d8f68d1676b040c8eb7ea3383</citedby><cites>FETCH-LOGICAL-c608t-7c626272a9b1f8d0b4e31dc7c4523f2afd8df615d8f68d1676b040c8eb7ea3383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-014-3500-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-014-3500-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25540087$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choi, Ji Min</creatorcontrib><creatorcontrib>Lee, Changhyun</creatorcontrib><creatorcontrib>Park, Jeong Hwan</creatorcontrib><creatorcontrib>Oh, Hyeon Jeong</creatorcontrib><creatorcontrib>Hwang, Sung Wook</creatorcontrib><creatorcontrib>Chun, Jaeyoung</creatorcontrib><creatorcontrib>Koh, Seong-Joon</creatorcontrib><creatorcontrib>Im, Jong Pil</creatorcontrib><creatorcontrib>Kim, Ji Won</creatorcontrib><creatorcontrib>Kim, Joo Sung</creatorcontrib><creatorcontrib>Kim, Byeong Gwan</creatorcontrib><creatorcontrib>Lee, Kook Lae</creatorcontrib><title>Complete Resection of Colorectal Adenomas: What Are the Important Factors in Fellow Training?</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>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.</description><subject>Adenomatous Polyps - pathology</subject><subject>Adenomatous Polyps - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biochemistry</subject><subject>Clinical Competence</subject><subject>Colonoscopy</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Colorectal Surgery - education</subject><subject>Comparative analysis</subject><subject>Education, Medical, Graduate</subject><subject>Fellowships and Scholarships</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical colleges</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pneumoviridae</subject><subject>Retrospective Studies</subject><subject>Seoul</subject><subject>Surgery</subject><subject>Transplant Surgery</subject><subject>Treatment Outcome</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkU-LFDEQxYMo7uzqB_AiAS9eeq1KupO0FxkGZ11YEGTFk4R0Oj3bS3cyJhkWv71pZv2LIjmkKvm9RxWPkGcI5wggXyUEwaACrCveQCkekBU2klesEeohWQGKUiOKE3Ka0i0AtBLFY3LCmqYGUHJFPm_CvJ9cdvSDS87mMXgaBroJU4ilNRNd986H2aTX9NONyXQdHc03jl7O-xCz8Zlujc0hJjp6unXTFO7odTSjH_3uzRPyaDBTck_v7zPycfv2evOuunp_cblZX1VWgMqVtIIJJplpOxxUD13tOPZW2rphfGBm6FU_CGx6NQjVo5Cigxqscp10hnPFz8jLo-8-hi8Hl7Kex2TLMMa7cEga25oxbBlv_48KJUBCUy_oiz_Q23CIviyyUA3ytgb1k9qZyenRDyFHYxdTvZbI2pq3gIU6_wtVTu_m0QbvhrG8_ybAo8DGkFJ0g97HcTbxq0bQS_r6mL4u6eslfQ1F8_x-4EM3u_6H4nvcBWBHIJUvv3Pxl43-6foNnsm2aA</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Choi, Ji Min</creator><creator>Lee, Changhyun</creator><creator>Park, Jeong Hwan</creator><creator>Oh, Hyeon Jeong</creator><creator>Hwang, Sung Wook</creator><creator>Chun, Jaeyoung</creator><creator>Koh, Seong-Joon</creator><creator>Im, Jong Pil</creator><creator>Kim, Ji Won</creator><creator>Kim, Joo Sung</creator><creator>Kim, Byeong Gwan</creator><creator>Lee, Kook Lae</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20150601</creationdate><title>Complete Resection of Colorectal Adenomas: What Are the Important Factors in Fellow Training?</title><author>Choi, Ji Min ; Lee, Changhyun ; Park, Jeong Hwan ; Oh, Hyeon Jeong ; Hwang, Sung Wook ; Chun, Jaeyoung ; Koh, Seong-Joon ; Im, Jong Pil ; Kim, Ji Won ; Kim, Joo Sung ; Kim, Byeong Gwan ; Lee, Kook Lae</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c608t-7c626272a9b1f8d0b4e31dc7c4523f2afd8df615d8f68d1676b040c8eb7ea3383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adenomatous Polyps - pathology</topic><topic>Adenomatous Polyps - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biochemistry</topic><topic>Clinical Competence</topic><topic>Colonoscopy</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Colorectal Surgery - education</topic><topic>Comparative analysis</topic><topic>Education, Medical, Graduate</topic><topic>Fellowships and Scholarships</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical colleges</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pneumoviridae</topic><topic>Retrospective Studies</topic><topic>Seoul</topic><topic>Surgery</topic><topic>Transplant Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Ji Min</creatorcontrib><creatorcontrib>Lee, Changhyun</creatorcontrib><creatorcontrib>Park, Jeong Hwan</creatorcontrib><creatorcontrib>Oh, Hyeon Jeong</creatorcontrib><creatorcontrib>Hwang, Sung Wook</creatorcontrib><creatorcontrib>Chun, Jaeyoung</creatorcontrib><creatorcontrib>Koh, Seong-Joon</creatorcontrib><creatorcontrib>Im, Jong Pil</creatorcontrib><creatorcontrib>Kim, Ji Won</creatorcontrib><creatorcontrib>Kim, Joo Sung</creatorcontrib><creatorcontrib>Kim, Byeong Gwan</creatorcontrib><creatorcontrib>Lee, Kook Lae</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Ji Min</au><au>Lee, Changhyun</au><au>Park, Jeong Hwan</au><au>Oh, Hyeon Jeong</au><au>Hwang, Sung Wook</au><au>Chun, Jaeyoung</au><au>Koh, Seong-Joon</au><au>Im, Jong Pil</au><au>Kim, Ji Won</au><au>Kim, Joo Sung</au><au>Kim, Byeong Gwan</au><au>Lee, Kook Lae</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complete Resection of Colorectal Adenomas: What Are the Important Factors in Fellow Training?</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>60</volume><issue>6</issue><spage>1579</spage><epage>1588</epage><pages>1579-1588</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><coden>DDSCDJ</coden><abstract>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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>25540087</pmid><doi>10.1007/s10620-014-3500-0</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0163-2116 |
| ispartof | Digestive diseases and sciences, 2015-06, Vol.60 (6), p.1579-1588 |
| issn | 0163-2116 1573-2568 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Adenomatous Polyps - pathology Adenomatous Polyps - surgery Adult Aged Aged, 80 and over Biochemistry Clinical Competence Colonoscopy Colorectal Neoplasms - pathology Colorectal Neoplasms - surgery Colorectal Surgery - education Comparative analysis Education, Medical, Graduate Fellowships and Scholarships Female Gastroenterology Hepatology Humans Male Medical colleges Medicine Medicine & Public Health Middle Aged Oncology Original Article Pneumoviridae Retrospective Studies Seoul Surgery Transplant Surgery Treatment Outcome |
| title | Complete Resection of Colorectal Adenomas: What Are the Important Factors in Fellow Training? |
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