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| 1 | Role of observation of live cases done by Japanese experts in the acquisition of ESD skills by a western endoscopist显示文摘AIM:To evaluate the role of observation of experts performing endoscopic submucosal dissection(ESD)in the acquisition of ESD skills.METHODS:This prospective study is documenting the learning curve of one Western endoscopist.The study consisted of three periods.In the first period(preobservation),the trainee performed ESDs in animal models in his home institution in the United States.The second period(observation)consisted of visit to Japan and observation of live ESD cases done by experts.The observation of cases occurred over a 5-wk period.During the third period(post-observation),the trainee performed ESD in animal models in a similar fashion as in the first period.Three animal models were used:live40-50 kg Yorkshire pig,explanted pig stomach model,and explanted pig rectum model.The outcomes from the ESDs done in the animal models before and after observation of live human cases(main study intervention)were compared.Statistical analysis of the data included:Fisher’s exact test to compare distributions of a categorical variable,Wilcoxon rank sum test to compare distributions of a continuous variable between the two groups(pre-observation and post-observation),and Kruskal-Wallis test to evaluate the impact of lesion location and type of model(ex-vivo vs live pig)on lesion removal time.RESULTS:The trainee performed 38 ESDs in animal model(29 pre-observation/9 post-observation).The removal times post-observation were significantly shorter than those pre-observation(32.7±15.0 min vs 63.5±9.8 min,P<0.001).To minimize the impact of improving physician skill,the 9 lesions post-observation were compared to the last 9 lesions pre-observation and the removal times remained significantly shorter(32.7±15.0 min vs 61.0±7.4 min,P=0.0011).Regression analysis showed that ESD observation significantly reduced removal time when controlling for the sequence of lesion removal(P=0.025).Furthermore,it was also noted a trend towards decrease in failure to remove lesions and decrease in complications after the period of observation.This study did not find a significant difference in the time needed to remove lesions in different animal models.This finding could have important implications in designing training programs due to the substantial difference in cost between live animal and explanted organ models.The main limitation of this study is that it reflects the experience of a single endoscopist.CONCLUSION:Observation of experts performing ESD over short period of time can significantly contribute to the acquisition of ESD skills. | Peter V Draganov Myron Chang Roxana M Coman Mihir S Wagh Qi An Takuji Gotoda | 2014 | World Journal of Gastroenterology2014，20，16： | 3 |
| 2 | Prospective e- valuation of the use of fully covered self-expanding metal stents for EUS-guided transmural drainage of pancreatic pseudocysts显示文摘 | Penn D E Draganov P V Wagh M S | 2012 | Gastrointest Endose2012，76，3： | 1 |
| 3 | Prospective evaluation of the use of fully covered self-expanding metal stents for EUS-guided transmural drainage of pancreatic pseudo- cysts显示文摘 | Penn D E Draganov P V Wagh M S Forsmark C E Gupte A R Chauhan S S | 2012 | Gastrointest Endosc2012，76，： | 1 |
| 4 | Amalnerkar,Surface cupricated SnO2-ZnO Thick Films as a H2S Gas Sensor显示文摘 | Wagh M S Patil L A Tanay Seth D P | 2004 | Materials Chemistry and Physics2004，84，23： | 1 |
| 5 | Materials Chemistry and Physics显示文摘 | Wagh M S Patil L A Seth T | 2004 | 84: 228 - 2332004，84，： | 1 |
| 6 | Surface cupricated SnO2-ZnO thick films as a HE S gas sensor 显示文摘 | Wagh M S Patil L A Amalnerkarb D P | 2004 | Mater Chem Phys2004，84，2： | 1 |
| 7 | Modified zinc oxide thick film resistors as NH3 gas sensor 显示文摘 | Wagh M S Jain G H Patil D R | 2006 | Sensors and Actuators B2006，115，1： | 1 |
| 8 | 显示文摘 | Wagh M S Patil L A Seth T | 2004 | Materials Chemistry and Physics2004，84，： | 1 |
| 9 | Surveillance and screening for Barrett esophagus and adenocarcinoma显示文摘 | Mashimo H Wagh M S Goyal R K | 2005 | J Clin Gastroenterol2005，39，42： | 1 |
| 10 | 显示文摘 | Wagh M S | 2004 | Materials Chemistry and Physics2004，，84： | 1 |
| 11 | Prospective evaluation of maternal mor-bidity and mortality in post-cesarean section patients admitted to postane-sthesia intensive care unit显示文摘 | Harde M Dave S Wagh S | 2014 | J Anaesthesiol Clin Pharmacol2014，30，4： | 1 |
| 12 | Gas holdup in a two-phase reversed flow jet loop reactor显示文摘 | S M Wagh K V Koranne R B Mankar | 2010 | The Canadian Journal of Chemical Engineering2010，88，5： | 1 |
| 13 | Prospective evaluation of maternal morbidity and mortality in post-cesarean section patients admitted to postanesthesia intensive care unit显示文摘 | Harde M Dave S Wagh S | 2014 | J Anaesthesiol Clin Pharmacol2014，30，4： | 1 |
| 14 | Surface cupricated SnO2-ZnO thick films as a H2S gas sensor显示文摘 | Wagh M S Patil L A Seth T | 2004 | Materials Chemistry and Physics2004，，84： | 1 |
| 15 | Surface cupricated SnO2-ZnO thick films as a H2S gas sensor显示文摘 | Wagh M S Patil L A Seth T | 2004 | Materials Chemistry and Physical2004，84，： | 1 |
| 16 | Surface cupriceted SnO2-ZnO thick films as a H2S gas sensor显示文摘 | WAGH M S PATIL L A TANAY S | 2004 | Mater Chem Phys2004，84，23： | 1 |
| 17 | Surface customization ofSn02 thick films using Ru02 as a surfactant for the LPG respon-se 显示文摘 | Wagh M S Jain G H Patil D R | 2007 | Sensors and Actuators B : Chemical2007，122，2： | 1 |
| 18 | Dendtritic Azido Ester: a Potential Energetic Additive for High Energy Material ( HEM ) Formulations 显示文摘 | Pant C S Wagh R M Nair J K | 2006 | Journal of Energetic Materials2006，24，4： | 1 |
| 19 | Patil modified zinc oxide thick film resistors as NH3 gas sensor显示文摘 | Wagh M S Jain G H Patil D R | 2005 | Sensors and Actuators B:Chemical2005，13，： | 1 |
| 20 | CuO-doped BSST thick film resistors for ppb level H2S gas sensing at room temperature显示文摘 | PATIL S A PATIL L A PATIL D R JAIN G H WAGH M S | 2007 | Sens Actual B2007，，： | 1 |
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