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经十二指肠镜肝肠吻合口良性狭窄双全覆膜自膨式金属支架置入术的前瞻性、多中心 II 期临床试验方案

Study protocol for a prospective, multicentre, phase II trial on endoscopic treatment using two fully covered self-expandable metallic stents for benign strictures after hepaticojejunostomy.

机构信息

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Chuo-ku, Japan.

Showa University Koto Toyosu Hospital, Koto-ku, Japan.

出版信息

BMJ Open. 2023 Dec 10;13(12):e078967. doi: 10.1136/bmjopen-2023-078967.

Abstract

INTRODUCTION

The current endoscopic treatment for postoperative benign hepaticojejunostomy anastomotic stricture (HJAS) has a high technical success rate and is highly effective in the short term. However, long-term results have shown a high rate of stenosis recurrence, which indicates an insufficient response to treatment. Three prospective studies on fully covered self-expandable metallic stent (FC-SEMS) treatment for benign HJAS used the stenosis resolution rate as the primary endpoint, and no study has yet used the long-term non-stenosis rate (at 12 months) as the primary endpoint.

METHODS AND ANALYSIS

We launched the 'saddle-cross study', which will be conducted as a multicentre, prospective intervention of endoscopic treatment using two modified FC-SEMSs (BONASTENT️ M-Intraductal) that have been improved for benign stenosis in patients with benign HJAS, with the long-term non-restenosis rate (at 12 months) as the primary endpoint. This study aims to evaluate the long-term non-restenosis rate (at 12 months) and safety of the saddle-cross technique for benign HJAS. We plan to enrol 50 participants.

ETHICS AND DISSEMINATION

This study has been approved by the Certified Review Board of the National Cancer Center, Japan (CRB3180009). The results will be reported at various conferences and published in international peer-reviewed journals.

摘要

介绍

目前,治疗术后良性胆肠吻合口狭窄(HJAS)的内镜治疗技术成功率高,短期效果显著。然而,长期结果显示狭窄复发率高,表明治疗反应不足。三项关于完全覆膜自膨式金属支架(FC-SEMS)治疗良性 HJAS 的前瞻性研究均将狭窄缓解率作为主要终点,尚无研究将 12 个月时的无狭窄率作为主要终点。

方法与分析

我们开展了“鞍型交叉研究”,这是一项多中心前瞻性内镜治疗干预研究,将使用两种改良的 FC-SEMS(BONASTENT️ M-Intraductal)对良性 HJAS 患者的良性狭窄进行治疗,以 12 个月时的无长期再狭窄率作为主要终点。本研究旨在评估鞍型交叉技术治疗良性 HJAS 的长期无再狭窄率(12 个月)和安全性。我们计划纳入 50 名参与者。

伦理与传播

本研究已获得日本国家癌症中心认证审查委员会(CRB3180009)的批准。研究结果将在各种会议上报告,并发表在国际同行评议期刊上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0534/10729169/0e58040e912e/bmjopen-2023-078967f01.jpg

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本文引用的文献

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