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RECRUITINGINTERVENTIONAL

Reducing Neoplasia Recurrence After Endoscopic Resection of Large Colorectal Polyps

Important: This information is not medical advice. Talk to your doctor about whether a clinical trial is right for you.

About This Trial

Large (≥20mm) colorectal polyps often harbor areas of advanced neoplasia, making them immediate colorectal cancer (CRC) precursors. Such polyps have to be completely removed to prevent CRC and to avoid surgery and/or adjuvant therapy. The laterally spreading lesions (LSLs) are removed via endoscopic mucosal resection (EMR). However, recurrence is common. New techniques for LSL resection (hybrid argon plasma coagulation (h-APC) margin and base ablation) have shown a reduction in recurrence following the interventions. We hypothesize that performing hybrid argon plasma coagulation (h-APC) margin and base ablation during EMR of large (≥20mm) colorectal LSLs will lead to lower rates of lesion recurrence compared to Snare tip soft coagulation (STSC) margin ablation.

Who May Be Eligible (Plain English)

Who May Qualify: - adult ≥18 years old - patients undergoing EMR for a large (≥20mm) colorectal LSL - patients providing written and willing to sign a consent form for study participation. Who Should NOT Join This Trial: - inflammatory bowel disease; - non-elective colonoscopy; - poor general health (American Society of Anesthesiologists classification \>III); - coagulopathy or thrombocytopenia (international normalized ratio ≥1.5 or platelets \<50 x 109/L); - pedunculated polyps (Paris class Ip, Isp); - overt signs of deep submucosal invasive cancer (JNET 3); - biopsy proven invasive carcinoma in a potential study polyp. - Pregnant women Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language
Inclusion Criteria: * adult ≥18 years old * patients undergoing EMR for a large (≥20mm) colorectal LSL * patients providing written and informed consent for study participation. Exclusion Criteria: * inflammatory bowel disease; * non-elective colonoscopy; * poor general health (American Society of Anesthesiologists classification \>III); * coagulopathy or thrombocytopenia (international normalized ratio ≥1.5 or platelets \<50 x 109/L); * pedunculated polyps (Paris class Ip, Isp); * overt signs of deep submucosal invasive cancer (JNET 3); * biopsy proven invasive carcinoma in a potential study polyp. * Pregnant women

Treatments Being Tested

PROCEDURE

Hybrid Argon Plasma Coagulation (h-APC)

The hybrid argon plasma coagulation (h-APC) combines an ablation technique (APC) with the option for submucosal saline injection using a high-pressure water jet. The technique allows for the lifting of dysplastic epithelium, creating a cushion under the mucosa to facilitate the ablation of larger areas more thoroughly and with higher energy settings, while posing a low risk for side effects or complications.

PROCEDURE

Snare tip soft coagulation (STSC)

The Snare tip soft coagulation (STSC) involves using a snare to remove polyps, while simultaneously applying soft coagulation to the surrounding tissue using a specialized tip on the snare.

Locations (1)

Centre Hospitalier de l'Université de Montréal
Montreal, Quebec, Canada