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Efficacy and Safety of Precut-EMR for Resecting of Colonic Polyp

Not Applicable
Withdrawn
Conditions
Colonic Polyps
Registration Number
NCT04253990
Lead Sponsor
Asan Medical Center
Brief Summary

This study was attempted to determine the efficacy and complication of precut EMR comparing with convetional EMR for resecting of 10 \~ 20 mm colon polyp through prospective, randomized controlled trial.

Detailed Description

In general, a potential risk of advanced colorectal neoplasia is proportional with size. However, recent study report that occurence rate of advanced neoplasia in small polyp is 9 \~ 10 %. And, incidence of interval cancer after screening colonoscopy was reported as 10 \~ 27%. So We can suspect that complete resection of small polyp is important. Previous study recommended that endoscopic submucosal dissection (ESD) is a safe and effective procedure for treating colon polyp larger than 20 mm because of high complete resection rate and low recurrence rate. In contrast, endoscopic mucosal resection (EMR) is more recommended for resecting colon polyp smaller than 20 mm because of technical ease and low rate of complication.

However, Complete resection rate of conventional EMR is 60 \~ 70%. In case of incomplete resection, local recurrence rate is higher than complete resection. And In case of adenocarcinoma, specimen of piecemeal resection cannot be evaluated a depth of invasion and resection margin, and physician cannot decide a therapeutic plan.

In precut-EMR, mucosal resection is performed after pre-incision around a polyp. When precut EMR of polyp \> 20 mm was performed in previous study, complete resection rate and en-bloc resection rate were higher and local recurrence rate was lower than conventional EMR. But, there is no study of comparsion precut EMR and conventional EMR for resecting colon polyp \< 20 mm. This study was attempted to determine the efficacy and complication of precut EMR comparing with convetional EMR through prospective, randomized controlled trial.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • All patients older than 20 years old who had 10~20 mm colon polyp and agreed to participate a research
Exclusion Criteria
  • Medication history of antiplatelet agent within a week of procedure.
  • Medical history of coagulopathy
  • More than American Society of Anesthesiology class III
  • Medical history of liver cirrhosis, chronic kidney disease, malignancy, inflammatory bowel disease, severe inflammatory disease.
  • pedunculated polyp and polyp with malignant potential.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Histologic complete resection ratebaseline ( enrollment of all planned patient)
Secondary Outcome Measures
NameTimeMethod
Complication such as perforation, bleedingbaseline ( enrollment of all planned patient)
Procedure timeprocedure

Trial Locations

Locations (1)

Asan Medical Center

🇰🇷

Seoul, Songpa-Gu, Korea, Republic of

Asan Medical Center
🇰🇷Seoul, Songpa-Gu, Korea, Republic of

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