HO DANG QUY DUNG（2015年1月）

REPORT ON TSUKUBA UNIVERSITY HOSPITAL VISIT

Period of visit: 18th - 31st January, 2015 at Endoscopy Center of UTH
Aims of visit:
- GI Endoscopy learning
- Discussion about Teleconference in Gastrointestinal Endoscopy between University of Tsukuba Hospital and Cho Ray hospital

First of all, I would like to thank very much to all doctors, nurses and staffs of Endoscopy Center. I have had many kind helps and supports of them during the time I have studied in Endoscopy Center of University of Tsukuba Hospital. I really feel like working in my hometown.
The Endoscopy Center was well-equipped with high resolution endoscopy systems. This is very important for diagnosis of early cancer. We hardly do detect early lesions without good imaging endoscopy system.
All doctors and nurses in Tsukuba hospital are very kind and friendly. They are always happy to help me, carefully explain all my questions. Endoscopists in this center have been well trained with good knowledge and skills for variety of endoscopic procedures. I would like to deeply thank them very much again.
Through two weeks, I have observed about 30 cases of EGD endoscopy, 30 conlonoscopy, 4 EMR cases (Endoscopic Mucosal Resection) for polypectomy, 4 early cancer lesions treated by ESD (Endoscopic Submucosal Dissection), 4 EUS procedures and 3 ERCP cases. It's quite good number, I think.
The following were what I have learnt:
1.　I have learnt how to manage the patients before and after the procedures. Management of quality on patient's medical documents, imaging storage system, disinfection in endoscopy…
2.　Detection of early lesions
・ Good preparation with bubble and mucus eradication before procedure
・ Carefully examination with white light endoscopy, NBI and magnifying endoscopy.
・ Chromoendoscopy: the benefit of routinely using Indigocarmine dye in endoscopy.
・ Crystal violet dye for diagnosing pit pattern in colorectal lesions.
・ The application of NBI magnifying imaging to detect early lesion in EGD and colonoscopy. I have a change to discuss with experienced endoscopists about how to recognize lesions and classify it by many different classifications applying in Japan currently such as Japanese classification for early esophageal cancer, gastric cancer and colorectal tumor (Sano/Hiroshima/ Showa/ NICE classification).
3.　ESD/EMR techniques for treatment of early cancer.
・ I have already had few experiences in such these techniques for simple and easy cases.
・ I have observed 4 ESD procedures during this course and I have learnt a lot by observing real live procedures and by discussing with experienced doctors. Japanese doctors are really experts in this field in the world, surely.
・ I have observed ESD procedures with lesions located in esophagus, stomach and colon.
・ It's quite excellent experiences for me in applying this technique in my clinical practice.
4.　EUS/ERCP
・ Because of short visit, there were few cases of EUS/ERCP, but I am very satisfied with what I have observed: A EUS case of Autoimmune pancreatitis (AIP) and 2 ERCP of Neuroendocrine tumor in head of pancreas and pancreatic cancer.
5.　My plan after this visit
・ Detection of early cancer
・ Endoscopic therapeutics by EMR/ESD
・ Teleconference in endoscopy will be established soon and it will be a good way for learning sharing experiences in GI endoscopy between two hospitals.
・ Although two week course seem to be quite short and quickly pass, I thought I have learnt a lot of things in endoscopy, from simple things to complex procedures related to high risk complications.

I would like to take this opportunity to express my profound gratitude and extend my sincere appreciation to:
- Prof. Akira Matsumura - Director of the University of Tsukuba Hospital
- Prof. Minoru Akiyama - Chief, Office for the Promotion of International Medical Affairs (OPIMA)
- Prof. Yuji Mizokami - Director of Endoscopy Center and all gastroenterologists
- Prof. Ichinosuke Hyodo - Chief of Gastroenterology Department
- Ms. Megumi Fukaya - Coordinator of OPIMA

Thank you very much for all your supports. I have had the great stay in Tsukuba. I did really enjoy it.
Finally, I do hope that we continue having good collaboration.

Photo at OPIMA after closing ceremony,From the left: Ms.Hanh, Dr.Akiyama, Dr.Trung, Dr.Zaboronok, Dr.Dung