Complete Histologic Resection of Adenomatous Polyps?

Completed

Conditions studied: Adenomatous Polyps

In brief

Colorectal cancer is the second most common cause of cancer death in the US. Colonoscopy is considered the best test colorectal cancer screening. It allows resection of adenomatous polyps (a known cancer precursor) and thus, interrupt the adenoma-carcinoma sequence. Despite the potential benefit of screening colonoscopy recent studies have reported cases of colorectal cancers in a short interval after prior screening or surveillance colonoscopies. One possible cause of such interval cancers may be incomplete resection of adenomatous polyps and hence ongoing growth and cancer development in such lesions. Complete resection may be particularly important for polyps of at least 5mm in size as up 10% of such polyps higher risk lesions as villous adenoma, tubulovillous adenoma, high grade dysplasia, or early carcinoma. Although adenoma resection of sessile and flat adenomatous polyps between 5 and 20mm is believed to be well standardized data on complete resection of adenomatous tissue are sparse. This may be related to the assumption that using a snare with electro-cautery will successfully remove the polyp and cauterize remaining marginal adenomatous tissue and hence completely remove and or destroy the lesion. The investigators are interested in examining how often sessile adenomatous polyps between 5 and 20mm are completely removed using standard polypectomy snare. The investigation was also directed at a comparison between complete resection of polyps between 5 and 9mm and 10 and 20mm.

Key facts

Study ID

NCT01224444

Run by

White River Junction Veterans Affairs Medical Center

People needed

269

Starts

2008-05-01

Expected to finish

2013-01-01

Last updated by the study team

2015-01-12

Who can join

Age: 40 and older, up to 85. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Any patient ≥40 and <85 who presents for a colonoscopy and does not meet any of the exclusion criteria mentioned below will be asked to participate
• All patients who are found to have colonic polyp between 5 and 20mm in size will be included in the study

You may not qualify if…

• Pedunculated polyps (estimated stalk diameter < 50% polyp head diameter, stalk at least 5 mm)
• Any suspicion of perforation or deeper defects after polypectomy, irrespective whether treated or not.
• Post-polypectomy bleeding requiring hemostasis.
• Patients with known inflammatory bowel disease or active colitis
• Patients who are receiving an emergency colonoscopy
• Poor general health (ASA class>3)
• Patients on coumadin or with coagulopathy with an elevated INR ≥1.8, or platelets <50.
• Poor bowel preparation
• Patients who do not consent
• Pregnancy

Where it is running

• Dartmouth Hitchcock Medical Center — Lebanon, New Hampshire, United States
• White River Junction VAMC — White River Junction, Vermont, United States

Full record on ClinicalTrials.gov

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