Sang Man Park, Min Kyu Jung, Seong Woo Jeon, Sung Kook Kim

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Sang Man Park, Min Kyu Jung, Seong Woo Jeon, Sung Kook Kim The Cap Assisted Technique Enhances the Colonoscopy Training : Prospective Study of Six Trainees. Sang Man Park, Min Kyu Jung, Seong Woo Jeon, Sung Kook Kim Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea Background Figure 1. colonoscopy success rate in cap and non cap group Colonoscopy and polypectomy have effectively reduced the incidence of colorectal cancer. Nowadays, competence in colonoscopy is one of the essential subjects of GI trainees. However, considerable training and experience is required for optimal performance of a colonoscopy. Method This study involved 6 colonoscopy trainees. Three of them used cap and the others did not. Each trainee performed 100 cases of screening colonoscopy from the beginnings. The success rate, cecal intubation time, polyp detection rate, adenoma detection rate, advanced adenoma detection rate, adenocarcinoma detection rate was checked. Success rate and cecal intubation time by every ten cases were reviewed and the differences of average success rate and average cecal intubation time between cap assisted group and non cap assisted group were assessed. Figure 2. Cecal intubation time in cap and non cap group Result The average success rate of each ten cases from first to last were 50%, 60%, 83%, 73%, 90%, 87%, 83%, 93%, 97%, 90% in cap assisted group and 53%, 40%, 33%, 47%, 60%, 73%, 73%, 73%, 90%, 90% in non cap assisted group. The average cecal intubation time were 20.7, 18.6, 13.8, 13.1, 11.3, 14.1, 13.4, 10.4, 11.2, 10.0 minutes in cap assisted group and 26.4, 23.9, 24.1, 24.0, 18.1, 17.3, 15.8, 14.9, 12.3, 10.2 minutes in non cap assisted group. Higher succese rate (p<0.05) and Shorter cecal intubation time (p<0.05) was checked in cap assisted group. But, there were no difference in polyp detection rate (45.3% vs 43%, p>0.05), adenoma detection rate (26.3% vs 25%, p>0.05), advanced adenoma detection rate (2.6% vs 0.6%, p>0.05), adenocarcinoma detection rate (5.3% vs 3%, p>0.05) among two group. (cap assisted group vs non cap assisted group) Reference Conclusion 1. Stevany L. Peters, Aliya G. Hasan, Nicole B. Jacobson, et al. Level of fellowship training increases adenoma detection rates. Clin gastroenterol hepatol 2010;8:439-442 2. Jae Il Chung, Nayoung kim, Min Sik Um, et al. Learning curves for colonoscopy: a prospective evaluation of gastroenterology fellows at a single center. Gut liver 2010;4:31-35. 3. Suck-Ho Lee, Il-Kwun Chung, Sun-Joo Kim, et al. An adequate level of training for technical competence in screening and diagnostic colonoscopy: a prospective multicenter evaluation of the learning curve. Gastrointest endosc 2008;67:683-9. 4. M. Fracchia, C. senore, P. Armaroli, et al. Assessment of the multiple components of the variability in the adenoma detection rate in sigmoidoscopy screening, and lessons for training. Endoscopy 2010;42:448-455. Cap assisted colonoscopy might be helpful in increasing the success rate and shortening the cecal intubation time in training period. Polyp detection rate, adenoma detection rate, advanced adenoma detection rate, adenocarcinoma detection rate in cap assisted group are increased, but there were no statistically significant difference among two group. (cap assisted group vs non cap assisted group)