Endoscopic surgical skill qualification system in Japan: Five years of experience in the gastrointestinal field
Endoscopic surgical skill qualification system in Japan: Five years of experience in the gastrointestinal field
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DOI：
10.1111/j.1758-5910.2009.00034.x
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发表时间：
2010-05-01
影响因子：
1
通讯作者：
Kitajima, M.
中科院分区：
文献类型：
--
作者：
Kimura, T.;Mori, T.;Kitajima, M.
简介：为了减少内窥镜手术的并发症，日本内窥镜外科学会成立了一个委员会，建立了内窥镜手术技能资格系统（ESSQS）。在此，我们报告五年来胃肠外科领域使用 ESSQS 所采用的方法和获得的结果。方法：第一次 ESSQS 审查于 2004 年进行，此后每年进行一次检查。申请人必须提交一份接受过手术（包括并发症）的患者名单以及一段显示相关手术程序的未经编辑的视频。为了评估申请人的视频，评审委员会制定了“共同标准”（60分）和“程序特定标准”（40分）。视频评审由两位评委独立完成，两位评委打分均在70分以上，则申请通过。结果：已有1369人报名，641人（46.8%）成功。该系统的主要问题是两位法官之间的一致率相对较低（k 值：0.29-0.40）。然而，成功申请者治疗的患者的并发症发生率 (4.3 +/- 6.8%) 明显低于失败申请者治疗的患者 (5.6 +/- 8.4%) (P = 0.0096)。结论：虽然 ESSQS 可以进一步改进，但该系统促进了培训并减少了并发症。
Introduction: To reduce the complications of endoscopic surgery, the Japan Society for Endoscopic Surgery formed a committee that established the Endoscopic Surgical Skill Qualification System (ESSQS). Here we report on the methods employed and results obtained with the ESSQS over five years in the field of gastrointestinal surgery.Methods: The first ESSQS review was performed in 2004, and examinations have been conducted once a year since then. Applicants must submit a list of patients on whom they have performed surgery (including complications) and an unedited video showing one of the relevant surgical procedures. To assess the applicants' videos, the judging committee prepared "common criteria'' (60 points) and "procedure-specific criteria'' (40 points). Assessment of videos was done independently by two judges, and the applicant passed the test if both judges assigned a score of 70 points or more.Results: There have been 1369 applicants, and 641 (46.8%) have been successful. The main problem with this system has been a relatively low rate of agreement between the two judges (k value: 0.29-0.40). However, the incidence of complications is significantly lower in patients treated by successful applicants (4.3 +/- 6.8%) than in those treated by failed applicants (5.6 +/- 8.4%) (P = 0.0096).Conclusion: Although the ESSQS could be further improved, this system promotes training and decreases complications.