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NCT04783961: COLD SNARE

Cold Snare Endoscopic Resection for Duodenal Adenomas

Completed Last updated 15 September 2022
What this trial tests

trial testing Cold snare endoscopic resection in Duodenal Adenomas in 10 participants. Completed in 31 December 2021.

Timeline
1 March 2021
Primary endpoint
31 December 2021
31 December 2021

Quick facts

Lead sponsorIstituto Clinico Humanitas
StatusCompleted
Study typeOBSERVATIONAL
Enrollment10
Start date1 March 2021
Primary completion31 December 2021
Estimated completion31 December 2021
Sites1 location across Italy

Drugs / interventions tested

Conditions studied

Sponsor

Istituto Clinico Humanitas

Who can join

Adults 18 to 99, any sex, with Duodenal Adenomas. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Non-ampullary sporadic duodenal adenomas (SDA) are rare lesions, incidentally discovered in up to only 5% of patients during routine endoscopy. In any case, these lesions require treatment due to their potential malignant transformation because of the adenoma-carcinoma sequence, occurring in 30-85% of cases. Endoscopic resection (ER) of SDA represents an attractive alternative to surgical resection in appropriately selected patients, with lower morbidity and mortality rates. However, most endoscopists are not keen to resect larger lesions due to the risk of complications. Indeed, endoscopic resection in the duodenum has unique challenges: thin wall, high vascularity, very limited space and harmful effects of bile and acid both acting on the ER defect. Cold snare endoscopic resection has been shown to be a viable method for removing colorectal lesions with comparable efficacy outcomes compared to conventional polypectomy/endoscopic mucosal resection (EMR) and a promising safety profile. As a matter of fact, adverse events associated with hot snare resection technique such as delayed bleeding, post-polypectomy syndrome, and perforation are all related to electrocautery-induced injury. Performing cold snare piece-meal resection and avoiding the need of thermal therapy, may have a major impact in the duodenum where the risk of delayed bleeding and perforation is consistent. The aim of this pilot study is to prospectively evaluate the feasibility and the efficacy in term of safety and efficacy of cold snare endoscopic resection.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Cold-snare endoscopic mucosal resection of large duodenal laterally spreading tumors: is cold the future gold standard?
    Geyl S, Schaefer M, Pioche M, Dahan M, et al · · 2022 · PMID 35777374 · DOI 10.1055/a-1841-5607

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