대장내시경 전임의 수련에서 실시간 회수시간 기록의 유용성

Usefulness of Real-time Measurement of Colonoscopy Withdrawal Time during Fellow Training

  • 태정현 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 정성애 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 전승정 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 노선희 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 최주영 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 강민정 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 정지민 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 김성은 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 심기남 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 정혜경 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 김태헌 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 유권 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소) ;
  • 문일환 (이화여자대학교 의학전문대학원 내과학교실, 의과학 연구소)
  • Tae, Chung-Hyun (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Jung, Sung-Ae (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Jun, Seung-Jung (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Roh, Sun-Hee (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Choi, Ju-Young (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Kang, Min-Jung (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Jung, Ji-Min (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Kim, Seong-Eun (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Shim, Ki-Nam (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Jung, Hey-Kyung (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Kim, Tae-Hun (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Yoo, Kwon (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine) ;
  • Moon, Il-Hwan (Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine)
  • 발행 : 2011.06.30

초록

목적: 대장내시경의 질 관리 지표로 회수시간이 중요하게 고려된다. 이번 연구에서는 대장내시경 검사 중 회수시간을 실시간으로 측정하여 검사자가 회수시간을 측정한다는 사실을 알고 있을 때, 회수시간에 유의한 변화가 있는지 알아보고 이에 따른 용종 발견율에 차이가 있는지 알아보고자 하였다. 대상 및 방법: 대장내시경 중 실시간으로 회수시간을 측정한 197건과 회수시간을 측정하지 않은 184건을 대상으로 하였다. 대장내시경은 4명의 내시경 전문의와 3명의 1년차 전임의가 참여하였다. 회수시간의 측정과 함께 연구 대상군의 나이, 성별과 장 정결도, 용종 발견율을 비교 분석하였다. 결과: 회수시간을 측정한 군과 측정하지 않은 군 사이에 나이, 성별, 장 정결도와 대장 용종의 과거력은 차이는 없었다. 전임의가 회수한 경우, 실시간으로 회수시간을 측정한 군에서 회수시간을 측정하지 않은 군보다 유의하게 높은 회수시간을 보였다. 그러나 전임의와 내시경 전문의 모두에서 회수시간의 측정에 따른 용종 발견율의 증가는 없었다. 결론: 회수시간을 실시간으로 측정하는 방법은 용종 발견율에 영향을 주지는 않았다. 그러나 전임의에서는 회수시간을 실시간으로 측정하는 방법이 실제로 더 많은 회수시간을 할애하여 검사하도록 하였다. 따라서 회수시간을 실시간으로 측정하는 방법은 전임의가 충분한 시간을 할애하여 검사하도록 수련하는데 좋은 방법이 될 수 있다.

Background/Aims: Attempts to increase colonoscopy withdrawal time have been the topic of several recent publications. We assessed whether the real-time measurement of withdrawal time affected the withdrawal time and polyp detection rate. Methods: Real-time colonoscopy withdrawal time was measured in 197 subjects in a study group and 184 subjects comprised a control group without real-time measurements. Colonoscopies were performed by four endoscopy specialists and three fellows during their first year of training. Withdrawal time, clinical features, bowel preparation, and polyp detection rates were comparatively analyzed. Results: No significant differences in age, gender, bowel preparation, or polyp history were found in the two groups. Withdrawal time was significantly higher in the study group than that in the control group when a fellow performed the withdrawal. However, polyp detection rate did not significantly increase in the study group, regardless of physician. Conclusions: Real-time measurement of colonoscopy withdrawal time did not increase polyp detection rate, but the withdrawal time was significantly higher when a fellow performed the withdrawal phase than when a specialist performed withdrawal. Therefore, the real-time measurement of colonoscopy withdrawal time seems to be a useful tool for fellow training.

키워드

참고문헌

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