Water-soluble contrast agent use in adhesional small bowel obstruction: a survey of surgical practices and clinical trial considerations.

IF 1.7 4区 医学 Q3 SURGERY
K Aimar, J Walshaw, A Peckham-Cooper, N Smart, L Magill, M J Lee
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引用次数: 0

Abstract

Background: The role of water-soluble contrast agent (WSCA) as a therapeutic tool in the nonoperative management of adhesional small bowel obstruction (ASBO) remains indeterminate. This survey aimed to understand current surgical practices in WSCA use in the conservative approach to ASBO, and to evaluate key design and feasibility factors to inform a future controlled trial of WSCA in ASBO.

Methods: This study is reported in line with CROSS guidance. The survey consisted of 16 questions organised into three sections: respondent characteristics, current decision-making and WSCA use, and opinions on future trial. Pilot testing was conducted before online distribution to surgeons in the UK delivering Emergency General Surgery. Descriptive analysis was performed.

Results: Of 73 total respondents, 52 (71.2%) were consultants. When treating ASBO conservatively, 80.8% (59/73) reported using WSCA in more than half of cases, but there was wide variation in timings, use and repeat challenges. Between 71.2% and 89.0% of respondents affirmed their willingness to adhere to specific trial protocols. Regarding feasibility, 76.7% (56/73) of respondents agreed or strongly agreed that they would be willing to recruit to a trial and 75.3% (55/73) agreed or strongly agreed that their unit would be able to deliver a trial.

Conclusions: The survey revealed widespread acceptance of WSCA as a therapeutic tool in ASBO among emergency general surgeons. Although practices around its administration varied, there was a clear readiness to adopt standardised protocols. The majority of respondents expressed support for a controlled trial comparing WSCA against a placebo.

水溶性造影剂在粘连性小肠阻塞中的应用:外科实践和临床试验考虑的调查。
背景:水溶性对比剂(WSCA)作为非手术治疗粘连性小肠梗阻(ASBO)的治疗工具的作用仍不确定。本调查旨在了解WSCA在ASBO保守入路中应用的当前外科实践,并评估关键设计和可行性因素,为未来WSCA在ASBO中的对照试验提供信息。方法:本研究按照CROSS指南报道。调查包括16个问题,分为三个部分:受访者特征,当前决策和WSCA使用,以及对未来试验的意见。在英国进行紧急普通外科手术的外科医生在线分发之前进行了试点测试。进行描述性分析。结果:73名受访者中,52名(71.2%)为咨询师。当保守治疗ASBO时,80.8%(59/73)报告半数以上的病例使用WSCA,但在时间、使用和重复挑战方面存在很大差异。71.2%至89.0%的受访者肯定他们愿意遵守特定的试验方案。在可行性方面,76.7%(56/73)的受访者同意或强烈同意他们愿意招募参加试验,75.3%(55/73)的受访者同意或强烈同意他们的单位能够进行试验。结论:调查显示,急诊普通外科医生普遍接受WSCA作为ASBO的治疗工具。虽然围绕其管理的做法各不相同,但显然准备采用标准化协议。大多数应答者表示支持对照试验比较WSCA和安慰剂。
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来源期刊
CiteScore
2.40
自引率
0.00%
发文量
316
期刊介绍: The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.
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