Prophylactic Coagulation for the Prevention of Bleeding in Endoscopic Mucosal Resection of Large Sessile Colonic Polyps
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Purpose
The hypothesis of this study is that prophylactic coagulation therapy with coagulation forceps to visible vessels within the mucosal defect for colonic Endoscopic Mucosal Resection (EMR) will reduce the rate of delayed bleeding when compared with current established standard EMR technique.
| Condition | Intervention |
|---|---|
|
Adenomatous Polyp of Large Intestine |
Procedure: Prophylactic use of coagulation therapy |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Supportive Care |
| Official Title: | Prophylactic Endoscopic Coagulation for the Prevention of Bleeding in Endoscopic Mucosal Resection (EMR) of Large Sessile Colonic Polyps: A Multi-centre, Randomised Control Trial |
- Presence of delayed bleeding [ Time Frame: 14 days ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 328 |
| Study Start Date: | May 2011 |
| Estimated Study Completion Date: | January 2015 |
| Estimated Primary Completion Date: | January 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| No Intervention: nil prophylactic coagulation | |
| Active Comparator: Prophylactic coagulation |
Procedure: Prophylactic use of coagulation therapy
The procedure is completed as per usual, and if the patient has been randomized to the intervention group the appropriate coagulation therapy will be applied immediately after standard EMR to visible vessels within the mucosal resection area.
Other Names:
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Detailed Description:
Delayed bleeding from the site of the resection remains one of the most common complications following EMR, occurring in up to 12% of patients. The purpose of the study is to prevent such bleeding with the use of a technique known as: "coagulation therapy." This therapy involves using a small dose of heat energy that results in clotting(coagulation) of a blood vessel. It is already used widely in the stomach and we intend using this on a lower setting to blood vessels that are exposed after the resection.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Patients referred to Westmead Hospital Endoscopy unit for endoscopic removal of a large sessile colonic polyp sized >20mm
- Age >18 years
- Able to give informed consent to involvement in trial
Exclusion Criteria:
- Pregnancy: currently pregnant or attempting to become pregnant
- Lactation: currently breastfeeding
- Taken clopidogrel within 7 days
- Taken warfarin within 5 days
- Had full therapeutic dose unfractionated heparin within 6 hours
- Had full therapeutic dose low molecular weight heparin (LMWH) within 12 hours
- Known clotting disorder
Contacts and Locations| Australia, New South Wales | |
| Westmead Hospital | Recruiting |
| Westmead, New South Wales, Australia, 2145 | |
| Contact: Michael Bourke 98459779 westmeadendoscopyresearch@gmail.com | |
| Contact: Rebecca Sonson 0298459779 bec2153@gmail.com | |
| Principal Investigator: Michael Bourke | |
| Sub-Investigator: Stephen Williams | |
| Sub-Investigator: Mahendra Naidoo | |
| Principal Investigator: | Michael J Bourke | Westmead Hospital - Endoscopy Unit |
More Information
No publications provided
| Responsible Party: | Professor Michael Bourke, Dr Michael Bourke, South West Sydney Local Health District |
| ClinicalTrials.gov Identifier: | NCT01368731 History of Changes |
| Other Study ID Numbers: | EMR-001-PEC, HREC2010/11/4.12(3155) AU RED |
| Study First Received: | June 6, 2011 |
| Last Updated: | June 12, 2013 |
| Health Authority: | Australia: Human Research Ethics Committee |
Additional relevant MeSH terms:
|
Colonic Polyps Hemorrhage Polyps Adenomatous Polyps Intestinal Polyps Pathological Conditions, Anatomical |
Pathologic Processes Adenoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms |
ClinicalTrials.gov processed this record on June 17, 2013