在患有结直肠病变的患者中预防后内镜下粘膜解剖凝血综合征的跨直肠排水管使用:多中心随机对照临床试验
Jingyi Liu1,2, Zhipeng Qi1, Dongli He2
1Endoscopy Center, Zhongshan Hospital of Fudan University, Shanghai, China.
The American journal of gastroenterology
|July 11, 2024
概括
跨直肠排水管 (TDT) 能够有效地防止在结直肠ESD后发生的后内镜下粘膜解剖 (ESD) 凝血综合征 (PECS). 这项随机试验表明,在接受TDTs的患者中,PECS发生率显著降低,突出显示了它们的预防作用.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床试验 临床试验
背景情况:
- 末尾镜下粘膜解剖后 (ESD) 凝血综合征 (PECS) 是结直肠ESD手术后的常见并发症.
- 越来越多的PECS发病率需要有效的预防策略.
- 这项研究旨在评估跨直肠排水管 (TDT) 预防PECS的有效性.
研究的目的:
- 评估跨直肠排水管 (TDT) 在预防后内镜下粘膜解剖 (ESD) 凝血综合征 (PECS) 的有效性.
- 为了比较患有结直肠ESD的患者的PECS发病率,包括和没有DTT安置.
主要方法:
- 一个多中心,随机对照试验,涉及224名接受结肠直肠ESD治疗的患者,病变≥20毫米.
- 患者被分配1:1接受跨直肠排水管 (TDT) 或没有TDT后手术.
- 插入TDTs在门上方10-15厘米,并在1-3天内移除.
主要成果:
- 与非TDT组相比,TDT组的PECS发生率明显较低 (6.25%与17.86%,P = 0.008).
- 亚组分析表明,TDT在预防女性PECS,瘤小于4厘米的患者,左侧结直肠瘤和更短的手术时间方面特别有效.
- 没有观察到与TDT相关的重大并发症,只有一个管道过早脱离.
结论:
- 跨直肠排水管 (TDT) 是一种有效的方法,可以减少后内镜下粘膜解剖 (ESD) 凝血综合征 (PECS) 的发生率,在接受结肠直肠ESD的患者中.
- TDT是预防这种常见的术后并发症的安全和有益的干预措施.
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