常规内镜评估结直肠瘤,以早期检测瘤泄漏 (REAL研究):为多中心前性研究的协议
Digestive surgery
|May 20, 2025
概括
这项研究引入了一种新的途径,用于在直肠手术后早期检测门泄漏 (AL),使用床边内镜来加快诊断和治疗.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 在直肠手术后,解剖管泄漏 (AL) 显著影响患者的治疗结果.
- 目前的诊断方法缺乏标准化,延迟了关键干预.
- 早期检测和及时治疗对于改善手术结果至关重要.
研究的目的:
- 评估一种新型的多中心临床护理途径,用于早期检测道泄漏 (AL).
- 评估将床边内镜整合到标准化的AL检测协议中.
- 缩短对AL的诊断和开始治疗的时间.
主要方法:
- 未来的,国际的,多中心的观察性研究.
- 使用床边数字直肠镜进行早期内镜检查 (手术后3-6天).
- 集成C-反应蛋白引导CT扫描和随访内镜.
主要成果:
- 主要结局是对AL诊断的时间.
- 二次结果包括诊断准确度,患者舒适度,口腔结膜率和长期解剖结膜愈合.
- 假设的诊断时间中位数从15天减少到5天.
结论:
- 该REAL研究旨在确定常规内镜评估途径是否可以缩短AL诊断时间.
- 这一途径旨在允许更早地启动对道泄漏的治疗.
- 这项研究将为在直肠外科手术中检测AL的标准化方法提供证据.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
38
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
38
Endoscopic Procedures II: Colonoscopy
41
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
41
Endoscopic Procedures I: Esophagogastroduodenoscopy
46
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
46
Endoscopic Procedures III: Video Capsule Endoscopy
65
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
65
Assessment of the Rectum and Anus
128
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
128
Endoscopic Procedures V: ERCP
51
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
51


