{
  "abstract": "Introduction Adoption of ESD has been limited and gradual in western centres due to the complexity of the procedure, a long learning curve, limited opportunities to train, and a lack of standard guidelines for training. Most ESD practitioners embark on training ‘in-post’ after specialisation and ESD fellowships are scarce. There are no reports from western centres of high volume ESD training of endoscopy fellows. The ESGE have published a recommended curriculum for ESD training, including a recommendation for 10 ESDs to be completed under mentorship before independent practice. We report on the experience of ESD training in a structured fellowship toward achieving this standard.Methods Patients who underwent colorectal ESD at a tertiary referral centre were included. Data recorded included procedure time, en bloc and R0 resection, complications and proficiency of resection in cm 2/hr. Outcomes of ESD performed by fellows were reported and time to achieve 10 independent resections under mentorship was calculated for those following a dedicated ESD training program.Results 1077 lesions were treated using ESD. Fellows performed part or complete ESD of 277 lesions at an average of 23 cases per fellow (range 3-105). 80% of fellow performed ESD were rectal lesions versus 57% of expert performed ESD. En bloc and R0 resection rates for ESD involving fellows were 99% and 85%. There was no difference in complications (p=0.75) between trainers and fellows. Mean proficiency of ESD involving fellows was 8.3cm2/hr, 5 of 12 fellows who performed ESD followed a dedicated ESD training program, all achieving 10 independently performed ESDs. 2 had interrupted training periods due to research and other commitments. For the rest, the time from first ESD experience in patients of any kind to completing the 10th independent ESD was 46, 52, and 33 weeks.Conclusion In one of the first reports of fellow training in significant volume of ESD in western centres, we demonstrate that structured training consistently results in achieving ESGE ESD training curriculum requirements within an acceptable fellowship period. Training can be achieved with high quality outcomes and acceptable proficiency without compromising patient safety.",
  "authors": [
    {
      "affiliations": [
        "King’s College Hospital, London, United Kingdom"
      ],
      "name": "Olaolu Olabintan"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, United Kingdom"
      ],
      "name": "Andrew Emmanuel"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, United Kingdom"
      ],
      "name": "Ali Eqbal"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, United Kingdom"
      ],
      "name": "Ciaran Judge"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, United Kingdom"
      ],
      "name": "Homira Ayubi"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, United Kingdom"
      ],
      "name": "Shraddha Gulati"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, United Kingdom"
      ],
      "name": "Bu’Hussain Hayee"
    },
    {
      "affiliations": [
        "King’s College Hospital, London, United Kingdom"
      ],
      "name": "Amyn Haji"
    }
  ],
  "title": "P441 High volume training of fellows in colorectal endoscopic submucosal dissection is feasible and safe in western centres",
  "uid": "ff1bbc4d-053e-5cb8-a591-724bf3f6df4d"
}