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ID 52740
フルテキストURL
著者
Higashi, Reiji Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol
Uraoka, Toshio Okayama Univ Hosp, Dept Endoscopy
Kato, Jun Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol
Kuwaki, Kenji Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol
Ishikawa, Shin Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol
Saito, Yutaka Natl Canc Ctr, Endoscopy Div
Matsuda, Takahisa Natl Canc Ctr, Endoscopy Div
Ikematsu, Hiroaki Natl Canc Ctr Hosp E, Div Digest Endoscopy & Gastrointestinal Oncol
Sano, Yasushi Sano Hosp, Gastrointestinal Ctr
Suzuki, Seiyuu Sumitomo Besshi Hosp, Dept Internal Med
Murakami, Yoshitaka Shiga Univ Med Sci, Dept Med Stat
Yamamoto, Kazuhide Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Gastroenterol & Hepatol
抄録
Background: Previous reports assessing diagnostic skill using narrow-band imaging (NBI) and pit pattern analysis for colorectal polyps involved only highly experienced endoscopists. Objective: To evaluate diagnostic skills of less-experienced endoscopists (LEE group) for. differentiation of diminutive colorectal polyps by using NBI and pit pattern analysis with and without magnification after an expanded training program. Design: Prospective study. Patients: This study involved 32 patients with 44 colorectal polyps (27 adenomas and 17 hyperplastic polyps) of 5 mm that were identified and analyzed by using conventional colonoscopy as well as non-magnification and magnification NBI and chromoendoscopy followed by endoscopic removal for histopathological analysis. Intervention: Before a training course, 220 endoscopic images were distributed in randomized order to residents with no prior endoscopy experience (NEE group) and to the LEE group, who had performed colonoscopies for more than 5 years but had never used NBI. The 220 images were also distributed to highly experienced endoscopists (HEE group) who had routinely used NBI for more than 5 years. The images were distributed to the NEE and LEE groups again after a training class. Magnification NBI and chromoendoscopy images were assessed by using the Sano and Kudo classification systems, respectively. Main Outcome Measurements: Diagnostic accuracy and interobserver agreement for each endoscopic modality in each group. Results: Diagnostic accuracy was significantly higher, and kappa (kappa) values improved in the LEE group for NBI with high magnification after expanded training. Diagnostic accuracy and kappa values when using high-magnification NBI were highest among endoscopic techniques for the LEE group after such training and the HEE group (accuracy 90% vs 93%; kappa = 0.79 vs 0.85, respectively). Limitations: Study involved only polyps of <= 5 mm. Conclusion: Using high-magnification NBI increased the differential diagnostic skill of the LEE group after expanded training so that it was equivalent to that of the HEE group.
発行日
2010-07
出版物タイトル
Gastrointestinal Endoscopy
72巻
1号
開始ページ
127
終了ページ
135
ISSN
0016-5107
資料タイプ
学術雑誌論文
関連URL
http://ousar.lib.okayama-u.ac.jp/metadata/52506
言語
English
論文のバージョン
author
査読
有り
DOI
Web of Sience KeyUT