Role of Hemostatic Powder (Endo-clotTM) in Prevention of Bleeding Within High Risk Patients After ESD
SD has become a standard treatment of gastric neoplasm confined to mucosa(epithelium). But after procedure, formation of iatrogenic gastric ulcer is inevitable. And Post ESD ulcer bleeding rate reported about 5% ~ 10% of all cases. Antiplatelet or anti-coagulation treatment might be associated higher incidence of rebleeding after ESD and iatrogenic ulcer bigger than 40mm in size is also associated.
Though several previous study have failed to show efficacy of 2nd look EGD, but those reports pointed out that visible vessels with current bleeding or highly suspect of recent bleeding (Forrest type IA~IIB) was observed about 10~20% of patients. Such patients are at high risk of bleeding.
So, Investigators hypothesize that appliance of Endo-Clot(TM) at post ESD ulcer have a significant role of protection from gastric acidic juice and help mucosa heal earlier. Thus visible vessels with risk of bleeding is going to be rarely observed at 2nd look EGD. And finally this protective effect might have an effect for prophylaxis of post ESD ulcer bleeding.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 3
Kontakter og lokationer
Studiesteder
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-
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Seoul, Korea, Republikken, 03722
- Yonsei university of medical center
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
A. Older than 19 years old and younger than 80 years old B. Pathologically confirmed gastric adenoma and/or early gastric cancer C. Iatrogenic gastric ulcer after ESD(Endoscopic submucosal dissection) more than 40mm (at prediction) D. Patients who is taking medication such at aspirin and/or coumadin (and other anti-coagulation medication) E. ECOG performance status 0 or 1 F. Adequate renal function (serum creatinine < 1.5 mg/dL or calculated creatinine clearance ≥ 60 ml/min) G. Adequate liver function (total bilirubin < 1.5 X the upper limits of normal (ULN), AST and ALT <3 X UNL, and alkaline phosphatases < 3 X ULN or < 5 x ULN in case of liver involvement) H. Adequate BM function (WBC ≥ 3,500/µl, absolute neutrophil cell count ≥ 1,500 /µl, platelet count ≥ 100,000/µl) I. Subjects who given written informed consent after being given a full description of the study
Exclusion Criteria:
A. Previously treated by radical gastrectomy B. Adverse effect on this medication C. Pregnant or on breast feeding D. Patients who are unwilling or unable to provide informed consent, such as those with psychiatric problem, drug abuse or alcoholism
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Eksperimentel: Endo-Clot(TM)
The intervention group
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After patients treated with ESD, Hemostatic power was applied on the post-resection surface by Endo-Clot™ system.
And treated with proton pump inhibitor as usual.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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the bleeding rate until 4 weeks after ESD
Tidsramme: POD ~ 4 weeks
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Post-ESD bleeding was defined by clinical symptoms or laboratory findings.
Clinical symptoms such as melena or hematemesis were defined as bleeding signs.
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POD ~ 4 weeks
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Forrest classification of the post-resection ulcer at 48 hours after ESD
Tidsramme: POD 2
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On POD 2, patients underwent scheduled second-look endoscopy 48 hours after ESD.
The artificial ulcer induced by ESD was evaluated and classified according to the Forrest classification.
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POD 2
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the bleeding rates according to timing and subgroup
Tidsramme: POD 0 ~ 4 weeks
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the bleeding rate until 4 weeks after ESD: Post-ESD bleeding was defined by clinical symptoms or laboratory findings.
Clinical symptoms such as melena or hematemesis were defined as bleeding signs.
(Acute bleeding: within 48 hours after ESD & Delayed bleeding: beyond 48 hours after ESD)
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POD 0 ~ 4 weeks
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Samarbejdspartnere og efterforskere
Sponsor
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Andre undersøgelses-id-numre
- 4-2015-0925
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
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Kliniske forsøg med Endo-Clot(TM)
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Yonsei UniversityUkendtBlødning ved mavekræftKorea, Republikken
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Yonsei UniversityAfsluttetHøjrisikopatienter for post-ESD-blødningKorea, Republikken
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Yonsei UniversityAfsluttetØvre gastrointestinale blødningerKorea, Republikken
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Policlinico HospitalRekrutteringSepsis | Kritisk sygdom | Fibrinolytisk defektItalien
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Medtronic - MITGAfsluttet
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Laboratoires PronutriExpert Clinical Services Organization (ECSOR)AfsluttetEndometrioseBelgien
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Erasmus Medical CenterUkendtVentrikulær takykardi | Iskæmisk kardiomyopati
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Jørgen Bjerggaard JensenAfsluttet