Background and aims:This study explored the efficacy of a prophylactic intestinal decompression tube in reducing the incidence of post-endoscopic submucosal dissection electrocoagulation syndrome(PECS).Methods:A total...Background and aims:This study explored the efficacy of a prophylactic intestinal decompression tube in reducing the incidence of post-endoscopic submucosal dissection electrocoagulation syndrome(PECS).Methods:A total of 157 eligible patients with colorectal mucosal lesions scheduled for endoscopic submucosal dissection(ESD)were prospectively recruited;after drop out 11 patients,146 patients were randomly assigned to an experimental group(group 1,n=73)or control group(group 2,n=73).Patients in the experimental group underwent placement of an intestinal decompression drainage tube after ESD,while the control group received no additional treatment after ESD.The primary outcome was the incidence of PECS.Secondary outcomes included the incidence of postoperative complications,time to removal of the intestinal decompression tube,the degree of abdominal pain as measured by the visual analog scale(VAS),and the participants’self-rated comfort level with the intestinal decompression tube.Results:A total of 146 patients(n=73 per group)were finally analyzed between July 2022 and February 2023.All tumors were successfully resected en bloc.A significant difference in the incidence of PECS was found between group 1 and group 2(5.5%vs 16.4%;P=0.034).Precisely,61.6%of patients felt painless for intestinal decompression tube,and no severe or unbearable pain was reported.Conclusions:The placement of intestinal decompression drainage tube could reduce the incidence of PECS after colorectal ESD,which might play a preventive role in the occurrence of PECS.展开更多
Background:Conservative therapy for Crohn’s disease(CD)-related acute bowel obstruction is essential to avoid emergent surgery.The present study aimed to evaluate the efficacy of using a long intestinal decompression...Background:Conservative therapy for Crohn’s disease(CD)-related acute bowel obstruction is essential to avoid emergent surgery.The present study aimed to evaluate the efficacy of using a long intestinal decompression tube(LT)in treatment of CD with acute intestinal obstruction.Methods:This is a prospective observational study.Comparative analysis was performed in CD patients treated with LT(the LT group)and nasogastric tube(the GT group).The primary outcome was the avoidance of emergent surgery.Additionally,predictive factors for failure of decompression and subsequent surgery were investigated.Results:There were 27 and 42 CD patients treated with LT and GT,respectively,in emergent situations.Twelve(44.4%)patients using LT were managed conservatively without laparotomy,while only nine(21.4%)patients in the GT group were spared from emergent surgery(P<0.05).Both in surgery-free and in surgery patients,the time to alleviation of symptoms was significantly shorter in the LT groups than in the GT groups(both P<0.01).C-reactive protein decrease after intubation and 48-hour drainage volume>500mL were predictors of unavoidable surgery(both P<0.05).The rate of temporary stoma and incidence of incision infection in the LT surgery group were significantly lower than those in the GT group(both P<0.05).No significant differences were observed in the frequency of medical and surgical recurrences between the LT and GT groups(all P>0.05).Conclusions:Endoscopic placement of LT could improve the emergent status in CD patients with acute bowel obstruction.The drainage output and changes in C-reactive protein after intubation could serve as practical predictive indices for subsequent surgery.Compared to traditional GT decompression,LT decompression was associated with fewer short-term complications and did not appear to affect long-term recurrence.展开更多
基金supported by the key Research foundation of China[grant number 2017YFC0112303]foundation of Science&Technology Department of Shenyang city[grant number 223213215]。
文摘Background and aims:This study explored the efficacy of a prophylactic intestinal decompression tube in reducing the incidence of post-endoscopic submucosal dissection electrocoagulation syndrome(PECS).Methods:A total of 157 eligible patients with colorectal mucosal lesions scheduled for endoscopic submucosal dissection(ESD)were prospectively recruited;after drop out 11 patients,146 patients were randomly assigned to an experimental group(group 1,n=73)or control group(group 2,n=73).Patients in the experimental group underwent placement of an intestinal decompression drainage tube after ESD,while the control group received no additional treatment after ESD.The primary outcome was the incidence of PECS.Secondary outcomes included the incidence of postoperative complications,time to removal of the intestinal decompression tube,the degree of abdominal pain as measured by the visual analog scale(VAS),and the participants’self-rated comfort level with the intestinal decompression tube.Results:A total of 146 patients(n=73 per group)were finally analyzed between July 2022 and February 2023.All tumors were successfully resected en bloc.A significant difference in the incidence of PECS was found between group 1 and group 2(5.5%vs 16.4%;P=0.034).Precisely,61.6%of patients felt painless for intestinal decompression tube,and no severe or unbearable pain was reported.Conclusions:The placement of intestinal decompression drainage tube could reduce the incidence of PECS after colorectal ESD,which might play a preventive role in the occurrence of PECS.
基金This study was supported by the National Natural Science Foundation of China(81770556).
文摘Background:Conservative therapy for Crohn’s disease(CD)-related acute bowel obstruction is essential to avoid emergent surgery.The present study aimed to evaluate the efficacy of using a long intestinal decompression tube(LT)in treatment of CD with acute intestinal obstruction.Methods:This is a prospective observational study.Comparative analysis was performed in CD patients treated with LT(the LT group)and nasogastric tube(the GT group).The primary outcome was the avoidance of emergent surgery.Additionally,predictive factors for failure of decompression and subsequent surgery were investigated.Results:There were 27 and 42 CD patients treated with LT and GT,respectively,in emergent situations.Twelve(44.4%)patients using LT were managed conservatively without laparotomy,while only nine(21.4%)patients in the GT group were spared from emergent surgery(P<0.05).Both in surgery-free and in surgery patients,the time to alleviation of symptoms was significantly shorter in the LT groups than in the GT groups(both P<0.01).C-reactive protein decrease after intubation and 48-hour drainage volume>500mL were predictors of unavoidable surgery(both P<0.05).The rate of temporary stoma and incidence of incision infection in the LT surgery group were significantly lower than those in the GT group(both P<0.05).No significant differences were observed in the frequency of medical and surgical recurrences between the LT and GT groups(all P>0.05).Conclusions:Endoscopic placement of LT could improve the emergent status in CD patients with acute bowel obstruction.The drainage output and changes in C-reactive protein after intubation could serve as practical predictive indices for subsequent surgery.Compared to traditional GT decompression,LT decompression was associated with fewer short-term complications and did not appear to affect long-term recurrence.
