title: Intermediate-length colonoscope needs more training duration than long-length colonoscope.
abstract: OBJECTIVE
  Few data are available on the influence of a colonoscope length for trainees, which could affect both the duration of training and colonoscopy quality. We conducted this study to validate which scope needs more duration for training to reach technical competence and to shows better quality indicators during diagnostic colonoscopy.
  
  
  METHODS
  We conducted a prospective randomly assigned study from April 2010 to February 2011 at Asan Medical Center. Among the 1329 patients enrolled, 1200 colonoscopies were analyzed. We compared cecal intubation rate, adenoma detection rate, cecal intubation time (<20 min), and withdrawal time between the trainees using the intermediate-length colonoscope and those using long-length colonoscope.
  
  
  RESULTS
  Trainees who used the long-length colonoscope showed a higher overall cecal intubation rate (88.2% vs. 81.0%, p = 0.001) and adenoma detection rate (49.7% vs. 34.2%, p < 0.001) than those using the intermediate-length colonoscope. The successful cecal intubation rate improved significantly and reached the requisite standard of competence (>90%) after 90 procedures in the long-length colonoscope group. However, the trainees using the intermediate-length colonoscope reached the requisite standard of competence after 150 procedures. Logistic regression analysis revealed that prolonged cecal intubation was associated with the use of the intermediate-length colonoscope, poor colon preparation, a small number of esophagastroduodenoscopy or sigmoidoscopy procedures conducted, and pain during procedures.
  
  
  CONCLUSIONS
  During the same training period, use of the long-length colonoscope in trainee was better in terms of reaching competency and quality indicators, and was less painful for the patients during colonoscopic procedures.
authors: Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine , Gumi , Korea.
authors: Yong Gil
authors: YG
authors: Kim
authors: Kyung-Jo
authors: KJ
authors: Kim
authors: Dong-Hoon
authors: DH
authors: Yang
authors: Byong Duk
authors: BD
authors: Ye
authors: Jeong-Sik
authors: JS
authors: Byeon
authors: Seung-Jae
authors: SJ
authors: Myung
authors: Suk-Kyun
authors: SK
authors: Yang
authors: Jin-Ho
authors: JH
authors: Kim
mesh_terms: D000046:Academic Medical Centers; D000236:Adenoma / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis*; D003110:Colonic Neoplasms / Q000175:diagnosis*; D020685:Colonoscopes; D003113:Colonoscopy / Q000193:education / Q000295:instrumentation* / Q000379:methods; D055088:Early Detection of Cancer; D005257:Fellowships and Scholarships / Q000592:standards; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D056910:Republic of Korea; D012307:Risk Factors; D013997:Time Factors
keywords: clinical competence; colonoscopy; education