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Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711]

van Brunschot, Sandra ; van Grinsven, Janneke ; Voermans, Rogier P ; Bakker, Olaf J ; Besselink, Marc G H ; Boermeester, Marja A ; Bollen, Thomas L ; Bosscha, Koop ; Bouwense, Stefan A ; Bruno, Marco J ; Cappendijk, Vincent C ; Consten, Esther C ; Dejong, Cornelis H ; Dijkgraaf, Marcel G W ; van Eijck, Casper H ; Erkelens, G Willemien ; van Goor, Harry ; Hadithi, Mohammed ; Haveman, Jan-Willem ; Hofker, Sijbrand H ; Jansen, Jeroen J M ; Laméris, Johan S ; van Lienden, Krijn P ; Manusama, Eric R ; Meijssen, Maarten A ; Mulder, Chris J ; Nieuwenhuis, Vincent B ; Poley, Jan-Werner ; de Ridder, Rogier J ; Rosman, Camiel ; Schaapherder, Alexander F ; Scheepers, Joris J ; Schoon, Erik J ; Seerden, Tom ; Spanier, B W Marcel ; Straathof, Jan Willem A ; Timmer, Robin ; Venneman, Niels G ; Vleggaar, Frank P ; Witteman, Ben J ; Gooszen, Hein G ; van Santvoort, Hjalmar C ; Fockens, Paul

BMC gastroenterology, 2013-11, Vol.13 (1), p.161-161, Article 161 [Periódico revisado por pares]

England: BioMed Central Ltd

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Título:
Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711]
Autor: van Brunschot, Sandra ; van Grinsven, Janneke ; Voermans, Rogier P ; Bakker, Olaf J ; Besselink, Marc G H ; Boermeester, Marja A ; Bollen, Thomas L ; Bosscha, Koop ; Bouwense, Stefan A ; Bruno, Marco J ; Cappendijk, Vincent C ; Consten, Esther C ; Dejong, Cornelis H ; Dijkgraaf, Marcel G W ; van Eijck, Casper H ; Erkelens, G Willemien ; van Goor, Harry ; Hadithi, Mohammed ; Haveman, Jan-Willem ; Hofker, Sijbrand H ; Jansen, Jeroen J M ; Laméris, Johan S ; van Lienden, Krijn P ; Manusama, Eric R ; Meijssen, Maarten A ; Mulder, Chris J ; Nieuwenhuis, Vincent B ; Poley, Jan-Werner ; de Ridder, Rogier J ; Rosman, Camiel ; Schaapherder, Alexander F ; Scheepers, Joris J ; Schoon, Erik J ; Seerden, Tom ; Spanier, B W Marcel ; Straathof, Jan Willem A ; Timmer, Robin ; Venneman, Niels G ; Vleggaar, Frank P ; Witteman, Ben J ; Gooszen, Hein G ; van Santvoort, Hjalmar C ; Fockens, Paul
Assuntos: Bacterial Infections - complications ; Bacterial Infections - surgery ; Clinical trials ; Complications and side effects ; Debridement - methods ; Diagnosis ; Drainage - methods ; Economic aspects ; Endoscopy ; Endoscopy - methods ; Evidence-based medicine ; Gastroenterology ; Health care ; Homeopathy ; Hospitals ; Humans ; Materia medica and therapeutics ; Medical care, Cost of ; Medical research ; Medicine, Experimental ; Minimally Invasive Surgical Procedures - methods ; Mortality ; Netherlands ; Older people ; Pancreatitis ; Pancreatitis, Acute Necrotizing - complications ; Pancreatitis, Acute Necrotizing - surgery ; Patient outcomes ; Study Protocol ; Therapeutics ; Treatment Outcome
É parte de: BMC gastroenterology, 2013-11, Vol.13 (1), p.161-161, Article 161
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-News-2
ObjectType-Feature-3
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Descrição: Infected necrotising pancreatitis is a potentially lethal disease that nearly always requires intervention. Traditionally, primary open necrosectomy has been the treatment of choice. In recent years, the surgical step-up approach, consisting of percutaneous catheter drainage followed, if necessary, by (minimally invasive) surgical necrosectomy has become the standard of care. A promising minimally invasive alternative is the endoscopic transluminal step-up approach. This approach consists of endoscopic transluminal drainage followed, if necessary, by endoscopic transluminal necrosectomy. We hypothesise that the less invasive endoscopic step-up approach is superior to the surgical step-up approach in terms of clinical and economic outcomes. The TENSION trial is a randomised controlled, parallel-group superiority multicenter trial. Patients with (suspected) infected necrotising pancreatitis with an indication for intervention and in whom both treatment modalities are deemed possible, will be randomised to either an endoscopic transluminal or a surgical step-up approach. During a 4 year study period, 98 patients will be enrolled from 24 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite of death and major complications within 6 months following randomisation. Secondary endpoints include complications such as pancreaticocutaneous fistula, exocrine or endocrine pancreatic insufficiency, need for additional radiological, endoscopic or surgical intervention, the need for necrosectomy after drainage, the number of (re-)interventions, quality of life, and total direct and indirect costs. The TENSION trial will answer the question whether an endoscopic step-up approach reduces the combined primary endpoint of death and major complications, as well as hospital stay and related costs compared with a surgical step-up approach in patients with infected necrotising pancreatitis.
Editor: England: BioMed Central Ltd
Idioma: Inglês

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Transluminal endoscopic step-up approach versus minimally invasive surgical step-up approach in patients with infected necrotising pancreatitis (TENSION trial): design and rationale of a randomised controlled multicenter trial [ISRCTN09186711]

England: BioMed Central Ltd

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