Background and Aims
Previous studies on pediatric endoscopic training have not examined in detail if adverse
events (AEs) are affected by the fellow’s training level. We aimed to determine whether
trainee presence and educational level increase AEs or operative time (OT) for pediatric
intestinal endoscopy.
Methods
This was a prospective observational study of AEs for all endoscopic procedures and
retrospective analysis of OT (time of endoscope insertion until removal) for a sample
of specified procedures at a tertiary children’s hospital. AEs were categorized by
severity grades: 1, home management; 2, outpatient evaluation; 3, hospitalization
and/or repeat endoscopy; 4, surgery and/or intensive care unit admission; and 5, death.
Results
A total of 15,886 procedures (6257 with trainee) including 1627 therapeutic procedures
(733 with trainee) were analyzed for AEs. Four hundred thirteen total AEs (2.60%)
and 213 AEs grade 2 to 4 (1.34%) were identified. Fellow presence at any training
level did not increase AE rates for any procedures. Median OT for 3762 EGDs decreased
from 17 to 11 minutes from the first quarter to the fourth quarter of first-year fellowship
and then remained stable. EGDs without fellows were shorter (9 minutes, P < .0001) compared with any training level. Median times of 1291 colonoscopies with
EGD decreased from 55 to 51 to 47 minutes for fellows in the first half, second half
of first-year fellowship, and second and third year, respectively. Attendings alone
were faster (37 minutes, P < .0001).
Conclusions
Current pediatric endoscopic training for is safe regardless of fellow training level.
Trainee efficiency improves during and after fellowship.
Abbreviations:
AE (adverse event), ASA (American Society of Anesthesiologists), IQR (interquartile range), OT (operative time), Q (quarter of academic year), SD (standard deviation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 19, 2018
Accepted:
July 11,
2018
Received:
February 28,
2018
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Mark at [email protected]
Identification
Copyright
© 2018 by the American Society for Gastrointestinal Endoscopy
