引用文本：林晓清. 日本消化道早癌内镜治疗医生的培训体系与个人培训体会[J/CD]. 消化肿瘤杂志（电子版）, 2025, 17(3):334-337.

作者：林晓清

单位：中山大学附属第一医院消化内科，广东 广州 510080

Author：Lin Xiaoqing

Unit：Department of Gastroenterology and Hepatology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China

摘要：

随着内镜技术的发展，内镜黏膜下剥离术（endoscopic submucosal dissection, ESD）已成为消化道早癌的重要治疗方式。如何规范培养具备独立操作ESD能力的医生，成为全球关注的课题。日本作为ESD技术的发源地，其培训体系具有高度参考价值。本文结合笔者在NTT东日本关东病院大圃研教授团队中的研修经历，介绍日本ESD医生的培训体系特点，包括医生的分层教学模式、从结直肠到胃的循序渐进式训练路径，以及术前策略制定、术中指导和术后反思构成的闭环训练机制。文章还结合笔者自身经历，归纳出“做好每一例ESD”所需的五项核心能力：规范的诊断思维、稳定的控镜能力、明确的治疗策略、并发症预判与处理能力，以及持续的自我反思。这些经验表明，ESD培训不仅是技术的传授，更是理念、规范与思维方式的塑造。期望本文对国内ESD培训体系建设与年轻医生成长路径的探索提供借鉴与启发。

关键词：内镜黏膜下剥离术; 消化内镜培训; 日本医学教育体系

Abstract：

With the advancement of endoscopic technology, endoscopic submucosal dissection (ESD) has become a key treatment modality for early gastrointestinal cancers. How to systematically train doctors to independently perform ESD has become a global concern. As the birthplace of ESD, Japan offers a highly valuable training system worthy of reference. Based on the author’s training experience with Dr. Ken Ohata’s team at NTT Medical Center Tokyo, this article outlines the key features of Japanese ESD training system, including a tiered teaching model, a step-by-step training pathway progressing from the colon to the stomach, and a closed-loop training approach consisting of preoperative planning, intraoperative guidance, and postoperative reflection. Drawing from personal experience, the author summarizes five core competencies essential for performing high-quality ESD procedures: standardized diagnostic thinking, stable endoscope control, clear therapeutic strategies, the ability to anticipate and manage complications, and a mechanism for continuous self-reflection. These insights highlight that ESD training is not merely the transfer of technical skills, but also the cultivation of clinical philosophy, standardization, and analytical thinking. It is hoped that this article can offer useful perspectives for developing ESD training systems in China and for guiding the professional growth of young endoscopists.

Key words：Endoscopic submucosal dissection; Endoscopy training; Japanese medical education system

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