Crohn Disease Clinical Trial
Official title:
Assessing the Feasibility and Safety of Using Intraoperative Ultrasound in Ileocolic Crohn's Disease - The IUSS Crohn's Feasibility Study
The aim of this study is to evaluate if an intraoperative protocol for Ultrasound scan (USS) is feasible and safe in patients undergoing elective surgery for ileocolic CD. The results of this study could guide the development of a larger randomised trial.
To date the intraoperative clinical assessment of location and extent of ileocolic CD has
been left at the discretion of the operating surgeon guided by a mixture of experience,
tactile feedback, macroscopic appearance and results of preoperative imaging, with
significant intra and inter surgeon variability, potentially resulting in long segments of
small bowel being removed unnecessarily, which is a significant concern in patients at risk
of several abdominal surgeries and of developing "short bowel syndrome". At surgery, the
operating surgeon also evaluates the full length of the small bowel to locate and assess
further areas of CD: a process called "disease mapping". This process is not only important
to intervene simultaneously on other CD segments causing complications, but also to provide
the IBD MDT team with a full evaluation of the extent and severity of CD in that particular
patient, in order to guide the tailored postoperative maintenance treatment.
A standardised approach to intraoperative evaluation of extent and location of CD is
desirable, based on reliable and reproducible techniques, minimising the risk of surgical
recurrence, optimising the decision making on maintenance treatment and follow-up, protecting
patients from unnecessary extended small bowel resections and risk of short bowel syndrome.
The study objectives are To evaluate the feasibility of using intraoperative USS in patients
with CD of the small bowel, and to describe the steps of the procedure.
To assess safety of the intraoperative USS procedure during surgery. To evaluate the
feasibility of study delivery, i.e. recruitment of study participants and retention at
follow-up visits.
To record surgical and patient outcomes up to 6 weeks To evaluate the direct and indirect
costs of a standardised intraoperative USS protocol.
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