METHODS: This study used guidelines related to radiation enteritis by searching a database. Four independent reviewers used the AGREE II evaluation tool to evaluate the quality of the included guidelines, collate their main recommendations, and analyze the highest evidence supporting the main recommendations.
RESULTS: Six diagnostic and therapeutic guidelines for radiation enteritis were included in this study, one of which, the American Society for Gastrointestinal Endoscopy guidelines, had an overall score of over 60%, which is worthy of clinical recommendation. In the diagnosis and treatment of radioactive rectal injury, the recommendations for hemorrhagic endoscopic treatment are mature and mainly include (I) argon plasma coagulation; (II) formalin treatment; (III) bipolar electrocoagulation; (IV) heater probe; (V) radiofrequency ablation; and (VI) cryoablation.
CONCLUSIONS: The methodological quality of radioactive enteritis guidelines is unequal; even in the same guidelines, different domains have a large difference. For radioactive rectal damage diagnosis, a type of endoscopic treatment recommendation is more mature, but the overall diagnosis and treatment of radioactive enteritis still lacks high-quality research evidence.
方法:本研究通过检索数据库使用与放射性肠炎相关的指南。四名独立审核员使用AGREEII评估工具来评估所包括的指南的质量,整理他们的主要建议,并分析支持主要建议的最高证据。
结果:本研究包括六项放射性肠炎的诊断和治疗指南,其中之一,美国胃肠内窥镜学会指南,总分超过60%,值得临床推荐。在放射性直肠损伤的诊断和治疗中,出血性内镜治疗的建议已经成熟,主要包括(I)氩离子凝固术;(II)福尔马林治疗;(III)双极电凝术;(IV)加热器探针;(V)射频消融;(VI)冷冻消融.
结论:放射性肠炎指南的方法学质量不平等;即使在同一指南中,不同的领域有很大的差异。放射性直肠损伤诊断,一类内镜治疗建议较为成熟,但放射性肠炎的整体诊断和治疗仍缺乏高质量的研究证据。