Effect of Training in Upper Endoscopic Biopsy

ABSTRACT

BACKGROUND/AIMS: The optimal number of biopsy samples and the detection rate of neoplastic lesions are not established. This study aimed to assess the current practice patterns and effects of training in upper endoscopic biopsy. MATERIALS AND METHODS: From May through July 2013, all the biopsy-proven lesions detected during diagnostic esophagogastroduodenoscopy were enrolled in a single teaching hospital of Korea. Endoscopic findings, including number of biopsied samples, discrepancy rates between endoscopic and histologic diagnosis, and endoscopists' experience, were retrospectively assessed. RESULTS: A total of 1,208 biopsy-proven lesions were enrolled. 76 (6.3%) lesions were determined to be neoplastic. The neoplasm detection rate of trainees was lower than that of faculty doctors (4.6% vs. 7.7%; OR, 0.57; P=0.024). The number of biopsied samples was not different between trainees and faculty doctors, although faculty doctors tended to identify more neoplastic lesions. The concordance rates between endoscopic and histologic diagnosis were improved with training for both total and benign lesions, but there was no changes in concordance for neoplastic lesions. CONCLUSIONS: Training should be focused on detection of neoplastic lesions so as not to overlook these diseases.