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RECRUITING
NCT04008407
NA

ESD for Colorectal LSL Using a Selective Strategy - a Prospective Cohort Study

Sponsor: Western Sydney Local Health District

View on ClinicalTrials.gov

Summary

Colonic Laterally spreading lesions (LSL) =\> 20mm are at high risk to progress to cancer. Overt stigmata of submucosal invasive cancer (SMIC) has been well characterized and includes ulceration and surface pit pattern changes as per the Kudo classification of type V. In a recent report, risk factors for LSL with SMIC and no overt stigmata (i.e. covert SMIC) were described. Resection of these lesions 'en-bloc' can allow for better histological staging and potentially reduce the need for surgical resection.

Official title: Endoscopic Submucosal Dissection for Sessile Polyps and Laterally Spreading Lesions of the Colorectum Using a Selective Strategy - a Prospective Cohort Study

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

391

Start Date

2017-08-14

Completion Date

2028-02

Last Updated

2025-03-27

Healthy Volunteers

No

Interventions

PROCEDURE

Endoscopic Submucosal Dissection

Endoscopic Submucosal Dissection (ESD) results in en-bloc resection of LSL, regardless of lesion size. This allows for accurate histopathological assessment of SMIC, R0/R1 resection and depth of invasion. ESD is considered a potentially curative for superficial cancers (T1a).

PROCEDURE

Endoscopic Mucosal Resection

EMR is the current standard for treating colonic LSL and has been validated to be safe and efficacious. LSLs =\> 20mm are frequently resected piecemeal. Recent research show that resection margin soft coagulation reduces recurrence rates to those similar to en-bloc resections.

Locations (1)

Westmead Endoscopy Unit

Westmead, New South Wales, Australia