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The Portsmouth protocol for intra-operative ultrasound of the small bowel in Crohn's disease.
Celentano, V; Beable, R; Ball, C; Flashman, K G; Reeve, R; Holmes, A; Fogg, C; Harper, M; Higginson, A.
Afiliación
  • Celentano V; Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
  • Beable R; University of Portsmouth, Portsmouth, UK.
  • Ball C; Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
  • Flashman KG; Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
  • Reeve R; Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
  • Holmes A; Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
  • Fogg C; Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
  • Harper M; Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
  • Higginson A; University of Portsmouth, Portsmouth, UK.
Colorectal Dis ; 22(3): 342-345, 2020 03.
Article en En | MEDLINE | ID: mdl-31652389
ABSTRACT

AIM:

Bowel preservation is paramount in Crohn's disease surgery as affected patients are typically young adults at risk of having several abdominal surgical procedures during their lifetime. Intra-operative assessment of the extent and location of Crohn's disease is not standardized and is left to a mixture of the surgeon's experience, tactile feedback, macroscopic appearance and preoperative imaging. The aim of this study was to describe the technical steps of a standardized protocol for intra-operative ultrasound assessment of the small bowel in patients undergoing surgery for ileocolic Crohn's disease.

METHOD:

After laparoscopic mobilization of the bowel, a periumbilical incision is performed for extracorporeal division of the mesentery and the resection and anastomosis. A gastrointestinal consultant radiologist, with expertise in Crohn's disease imaging and abdominal ultrasound, performs full intra-operative assessment of the small bowel by applying a sterile ultrasound probe directly to the bowel, prior to resection being performed by the surgeon. The bowel is assessed through the wound protector with a sterile technique and the length, location and number of segments is documented together with further quantitative assessment using the METRIC (MR enterography or ultrasound in Crohn's disease) scoring guide.

RESULTS:

A step-by-step protocol for intra-operative ultrasound evaluation of the entire small bowel is described.

CONCLUSIONS:

A standardized approach to intra-operative evaluation of the extent and location of Crohn's disease is desirable. Intra-operative ultrasound may provide added value for assessment of proximal and multifocal Crohn's disease.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Enfermedad de Crohn / Laparoscopía Tipo de estudio: Diagnostic_studies Límite: Adult / Humans Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Reino Unido

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Enfermedad de Crohn / Laparoscopía Tipo de estudio: Diagnostic_studies Límite: Adult / Humans Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Reino Unido