1. Project title
Development of bronchoscope teqnique and spreading reｌated device in Vietnam
2. Country nameSocialist Republic of Vietnam
3. BackgroundContinuing from the previous 2 years, targeting Vietnam because of the detailed understanding of
the current situation and needs, and deep relationships and no linguistic obstacles for project leader.
For the current situation and issues until the previous year, see the previous year's planningdocument, reports, and attached documentation.
The main subjects of technology transfer / device deployment is transbronchial ultrasound (EBUS),and we also educate matters need for preliminary assessment and for implementation. In theprevious years, a total of 44 Vietnamese doctors and nurses from 17 hospitals visit Japan, and in themembers 29 Vietnamese doctors and nurses participated in 3 weeks training coarse, and we holdrelated lectures at the congress of the Vietnam Respiratory Society 2018 and so on, and actually at 6hospitals, which are central hospitals and bronchoscopy educational hospitals in Vietnam, about 70
cases of inspection were done bronchoscopy with EBUS safely and with high accuracy. For details,
refer to the report of 2017 and 2018. EBUS should be a technique to be commonly done in routine
practice, preparations for insurance inclusion are proceeding. We have already started collaboratingwith the existing bronchoscopy education program in Vietnam from the previous year and this year
we will continue to cooperate with the Vietnamese Respiratory Society fully, and in the future wewill develop this project of EBUS to the provincial hospital level throughout Vietnam.
4. Objective
Continuing this year, with the full cooperation of the Vietnamese Respiratory Society, we aim to further expansionof medical institution to training, completion the textbook started writing from the previous year, further improve
the knowledge, technology and experience among doctors who received the previous year's training to be doctors
who will lead the EBUS development in Vietnam.
In addition, we will play an auxiliary role in establishing the respiratory endoscopic education center for the wholeof Vietnam and Southeast Asia, and we will be a bridge between related academic societies in Japan and theVietnamese Respiratory Society.
5. Project outline

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It is a project on technique of examination conducted using products of Olympus, a Japanesecompany. In addition, recently it has become common all over the world, but flexible bronchoscopy
began in Japan and Japan is leading the world of technique of it.
Flexible bronchoscopy not including EBUS is a general exam which has already been done also inprovincial hospital level in Vietnam and of cause included in health insurance system. Regarding
additional health insurance adaptation when using EBUS, the Vietnamese Respiratory Society is
active for future introduction. Regarding the use of new medical devices in Vietnam, we have been
conducting examination on actual cases at a few medical institutions in the previous years, andvarious problems have been resolved at that time. Because it is a technique to add on the existingbronchoscopy examination, it is presumed that it is possible to spread whole country on the existing
medical system.
In previous year, we are targeting some leading medical institutes throughout Vietnam under thefull backup of the Vietnamese Respiratory Society. Although it is a useful examination for diagnosisof rare diseases, the main diseases to be examined are lung cancer and tuberculosis, which are very
numerous number of patients. Even among lung cancers with a high number of patients and highmalignancy, even though therapeutic drugs are available in national TB program, the spread ofmultidrug-resistant TB in the worst level in the world. To against this situation, more early
diagnosis and more frequent checking susceptibility test of anti TB drugs before treatment are oneof the urgent tasks that could be improved by spreading EBUS.
it is difficult to estimate the number of patients who get benefit from EBUS, because it is adiagnostic technique with so many kinds of disease (2018 In cooperation with the Vietnamese
Respiratory Society we plan to try to estimate). But now patients having indication of EBUS-related
examination should be tried diagnosis with a very invasive alternative examination, be abandoned
the diagnosis and treatment, be gave up early diagnosis and wait becoming severer to diagnosis in
the other way, or to take invasive treatment without diagnosis, etc. Induction of EBUS throw thisproject might be a great influence on public health and medical level.
EBUS is also described in the global guidelines, and also is the technique and examination thatare commonly carried out in developed countries, and in neighboring countries of Southeast Asia
6. Implementation structure
6-1. Japanese side
All of members of NCGM Respiratory Medicine; increase work by 3 to 5% for each member.
Mr. M. Hashimoto, the deputy director, will continue to take over as the leader of this project.
Estimated Increase work by 10%.
* This year's teaching materials can be almost shared with those created last year
* Because there is no linguistic barrier, it is guidance with the same feeling as accepting excellent
domestic trainees.
Equipment mainly uses existing facilities of NCGM and Olympus Japan's training laboratory.
We plan to visit other medical institutions as appropriate.
The funds from this project are used according to the budget plan.
6-2. Counterpart country side

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<Medical institutes for training in NCGM>
We will target many medical institutes as much as possible, which conduct respiratory endoscopy ofall Vietnam. At the time of planning, in addition to the four educational top hospitals thatparticipated this project in 2017, expand to the cancer hospital (K), military hospitals (108 others),
university hospitals etc. We also encourage participation of provincial level hospitals expecting
future development.
< Trainee for training course in NCGM>
As in last year, the main target is doctors. We will also accept nurses who work to help doctors inbronchoscopy at the same time. Recruitment will be mainly done by the Vietnamese Respiratory
Society, and recruits and selects promising doctor nurses in the future. In more detail, please refer
to another document about application.
<Participation in congress of Japanese rerated Societies>
Invite Vietnamese doctors to the Japan Society for Respiratory Endoscopy (Shinjuku, Tokyo) in2018, and short-term visit NCGM to grasp the situation of bronchoscope in Japan. Assume bosses ofparticipants in NCGM training.
<Institutes in Vietnam for technical assistance>
We target about 10 institutes, including medical institutes participated in the previous year's
training and medical institutes in a public and educational position newly included. As the academicsocieties, we contact and cooperate with the Vietnamese Respiratory Society, as appropriate, theHanoi Respiratory Society · Ho Chi Minh Respiratory Society.
Cooperation from the planning stage of the Vietnamese Respiratory Society, recruitment selection oftrainees etc. Participating medical institutes solve some In-hospital procedures for theimplementation of examination at the site.
Bach Mai Hospital, Cho Ray Hospital, Vietnamese Lung Hospital, Pham Ngoc Thach Hospital
Hanoi Medical University Hospital, Ho Chi Minh Medical University Hospital
Vietnam cancer (K) hospital, military hospital (108, 103, others)
Large scale items (Hai Duong, Hai Phong, Can tho, etc.) at various provincial hospitals anduniversity hospitals.

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7. Indicator

7-1. Output

7-2. Outcome

7-3. Impact

16 medical staffs will Join NCGM 3 weeks training, 50% improvement in results by
pre / post test
In technical guidance in Vietnam, more than 10 doctors will be under direct guidance
examination.
More than 200 audience are expected for related lectures such as the Vietnamese
Respiratory Society and the other congress, meeting.
Create a textbook under the name of Vietnamese Respiratory Society and distributeit free of charge, for doctor and nurses related to respiratory endoscopes in Vietnam
who could not participate directly in the training course, estimated to about 150
people in provincial, regional hospitals that is carrying out bronchoscopy or wanting
to do it in the future, estimated at about 100 organizations.
Number of EBUS-related examination, more than 50 under direct guidance ofJapanese expert and 50 without direct instraction of expert.
More than 2 institutes purchase EBUS system or related equipment.

From the high original needs, it is estimated that probably Vietnamese doctors willcontinue their efforts to introduce technology after the project (Vietnamese doctors
and nurses are saying that this project is very effective and useful as a training
about EBUS and bronchoscopy. So we would like to continue this project as much as
possible while there are needs). It is hoped that EBUS spread to all hospitals at theprovincial hospital level. This project will be the starting point of the stream.
Examination under EBUS will be included in the health insurance system inVietnam.

8. Main activities
8-1. Training in 20191)

Training in NCGM hospital about EBUS and matters related in bronchoscope includingreading CT and so on, 6 courses of 3 weeks training for 16 medical staffs.

2)

Help technically conducting bronchoscopy with EBUS for actual patients in Vietnam andjoin educational programs for Vietnamese bronchoscopists as a lecturer

3)

Wright a textbook for bronchoscope with Vietnamese Society of Respiratorogy in
Vietnamese.

4)

Develop the relationship between Respiratory Society of two countries and other relatedSocieties.

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