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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 | Chemoprotective mechanism of the natural compounds, epigallocatechin-3- O-gallate,quercetin and curcumin against cancer and car- diovascular diseases 显示文摘 | Jagtap S Meganathan K Wagh V | 2009 | Current Medicinal Chemistry2009，16，12： | 1 |
| 3 | Extraction and purifi-cation of tannase by reverse micelle system显示文摘 | Gaikaiwari R P Wagh S A Kulkarni B D | 2012 | Separation andPurification Technology2012，，89： | 1 |
| 4 | 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 |
| 5 | 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 |
| 6 | 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 |
| 7 | NVH challenges for low cost and light weight small cars显示文摘 | Wagh S B P Hudson D | 2011 | SAE International Jour- nal of Passenger Cars-Mechanical Systems2011，4，2： | 1 |
| 8 | Corrosion behaviour of metals and alloys in the waters of the arabian sea显示文摘 | Sawant S S Wagh A B | 1990 | Corrosion Prevention and Control1990，37，： | 1 |
| 9 | 查看详情显示文摘 | Dasgupta S Banerjee K Utture S Kusari P. Wagh S. Dhumal K. Kolekar S. Adsule P.G | | 0，，： | 1 |
| 10 | Corrosion Behaviour of Metals and Alloys the Waters of the Arabian Sea显示文摘 | SAWANT S S WAGH A B | 1990 | Corrosion prevention and Control1990，36，： | 1 |
| 11 | Materials Chemistry and Physics显示文摘 | Wagh M S Patil L A Seth T | 2004 | 84: 228 - 2332004，84，： | 1 |
| 12 | 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 |
| 13 | Stabilization of Rocky Flats Pu-contaminated Ash Within Chemically Bonded Phosphate Ceramics显示文摘 | Wagh A S Sengupta P Jeong S Y | 1999 | Journal of Nuclear Materials1999，265，： | 1 |
| 14 | Met-related receptor tyrosine kinase Ron in tumor growth and metastasis 显示文摘 | WAGH P K PEACE B E WALTZ S E | 2008 | Adv Cancer Res2008，100，： | 1 |
| 15 | 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 |
| 16 | Corrosion of Metals and Alloys in the Coastal and Deep Waters of the Arabian Sea and the Bay of Bengal显示文摘 | SAWANT S S VENKAT K WAGH A B | 1993 | Corrosion of Matels and Alloys1993，20，： | 1 |
| 17 | Mercury stabilization in chemically bonded phosphate ceramics显示文摘 | WAGH A JEONG S | 1998 | Ceramic Transactions1998，，87： | 1 |
| 18 | 显示文摘 | Wagh M S Patil L A Seth T | 2004 | Materials Chemistry and Physics2004，84，： | 1 |
| 19 | 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 |
| 20 | 显示文摘 | Wagh M S | 2004 | Materials Chemistry and Physics2004，，84： | 1 |
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