Abstract:
BACKGROUND:Ileoscopy is the criterion standard for mucosal lesions of terminal ileum but is performed in 5% of colonoscopy activity, and the need for training is undefined. OBJECTIVE:To assess the learning curve and skill-keeping line of ileoscopy. DESIGN:Prospective randomized study. SETTING:Single GI endoscopy unit. PATIENTS:Adult outpatients referred for colonoscopy. INTERVENTIONS:Patient randomization to ileocolonoscopy by trainees and seniors. MAIN OUTCOME MEASUREMENTS:Ileoscopy skill was divided into the following: ileocecal valve (ICV) intubation (success rate, time) and ileal exploration (length, time). Consecutive blocks of 10 procedures were used to calculate the learning curve and the skill-keeping line. Variables considered to influence ICV intubation were the following: endoscopist experience, ICV morphology, patient age, gender, body mass index, diverticular disease, and preceding abdominal/pelvic surgery. RESULTS:Learning curve showed that competency in ICV intubation (80% success rate) and ileal exploration (16 cm) was achieved after 50 procedures. The skill-keeping line showed that ileoscopy was easy (97% success rate), fast (1 minute), and well accepted up to 45 cm of the ileum. Thin-lipped and volcanic ICV are the most difficult and easiest to intubate, respectively. Crohn's disease and adenomas of the proximal edge of ICV were diagnosed in 2.2%. CONCLUSIONS:Training in ileoscopy is recommended to achieve competency, and endoscopists should consider practicing ICV intubation to maintain and increase their skill. Ileoscopy can be difficult when the ICV is thin lipped or single bulged, and easy when it has a volcanic morphology.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Iacopini G,Frontespezi S,Vitale MA,Villotti G,Bella A,d'Alba L,De Cesare A,Iacopini Fdoi
10.1016/j.gie.2005.09.029keywords:
subject
Has Abstractpub_date
2006-02-01 00:00:00pages
250-6issue
2eissn
0016-5107issn
1097-6779pii
S0016-5107(05)02827-0journal_volume
63pub_type
杂志文章,随机对照试验abstract:BACKGROUND:To assess the efficacy of adjuvant sclerotherapy after banding for the treatment of esophageal varices, a randomized trial was carried out of endoscopic variceal ligation (EVL) alone with sequential sclerotherapy versus sequential ligation-sclerotherapy (SLS) after banding with respect to variceal eradicatio...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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