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Effect of Water Exchange Method on Adenoma Miss Rates in Patients Undergoing Selective Polypectomy

25. august 2016 opdateret af: Yanglin Pan, Air Force Military Medical University, China

Effect of Water Exchange Method on Adenoma Miss Rates in Patients Undergoing Selective Polypectomy: a Single-centered, Randomized Controlled Study

Patients with colorectal adenomas are suggested to receive polypectomy. A substantial number of adenomas may be missed in patients with polyps found by previous colonoscopy. And water exchange (WE) method may increase the detection of missed adenoma compared with traditional air insufflation (AI) colonoscopy. The investigators aim to investigate whether water exchange colonoscopy method, compared with air insufflation method, can improve the detection of missed adenomas in patients undergoing selective polypectomy.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

For WE method, the air pump was turned off for the full duration of insertion to avoid inadvertent air insufflations and colon elongation. Residual air in the lumen was suctioned to minimize angulations at flexures. Water at 37°C was infused with a pump (Olympus) through the biopsy channel to confirm correct tip orientation for scope advancement. The infused water was removed predominantly by suction when the colonoscope was smoothly advanced during the insertion phase, and turbid luminal water due to residual feces was exchanged by clean water until the lumen was clearly visualized. Occasionally, if it was difficult to determine whether the colonoscope tip was in the cecum, air was allowed to be insufflated for observation. If the position of the scope tip was confirmed to be not in the cecum, insufflated air would be removed by suction and the WE method would be continuously used until successful intubation.

For the AI method, water was not used, and air was insufflated during insertion.

Air was insufflated to distend the lumen for inspection and biopsy or polypectomy during withdrawal for both methods. Polyps will be removed by forceps biopsy (polyps size <3mm), cold snare technique (3-6mm) or endoscopic mucosal resection (size≥6mm).

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

450

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Kina
    • Shaanxi
      • Xi'an, Shaanxi, Kina, 710032
        • Rekruttering
        • Endoscopic center, Xijing Hospital of Digestive Diseases
        • Kontakt:
        • Ledende efterforsker:
          • Gui Ren, MD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 80 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Age 18-80 patients undergoing selective polypectomy

Exclusion Criteria:

  • Polyps found more than 6 months
  • Patients with polyposis syndrome or hereditary nonpolyposis colorectal cancer
  • Patients with history of inflammatory bowel disease
  • Patients with planning to undergo Endoscopic Submucosal Dissection(ESD)
  • Patients not undergoing standard bowel preparation
  • Patients with solid feces in the last stool after bowel preparation
  • Patients considered to be high risk for bleeding during Endoscopic mucosal resection (EMR), e.g. using antiplatelet drugs (clopidogrel) within 5 days before the current colonoscopy
  • Hemodynamically unstable
  • Pregnant women
  • Unable to provide informed consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Water exchange (WE) method
Water exchange (WE) method was used for insertion to the cecum.
Andet: Water exchange (WE) method
Water exchange (WE) method was used for insertion to the cecum. And air was insufflated to distend the lumen for inspection and biopsy or polypectomy during withdrawal procedure.
Aktiv komparator: Air insufflation (AI) method
Air insufflation (AI) method was used for insertion to the cecum.
Andet: Air insufflation (AI) method.
Air insufflation (AI) method was used for insertion to the cecum. And air was insufflated to distend the lumen for inspection and biopsy or polypectomy during withdrawal procedure.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Adenoma miss rate
Tidsramme: 12 months
Adenoma miss rate was calculated as the number of patients with one and more additional adenomas during polypectomy procedure divided by the total number of patients in each group.
12 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
adenoma-level miss rate
Tidsramme: 12 months
Adenoma-level miss rate was calculated as the number of additional adenomas detected in polypectomy procedure divided by the total number of adenomas in each group.
12 months
Advanced adenoma miss rate/Miss advanced adenoma per colonoscopy
Tidsramme: 12 months
Advanced adenoma: any with 3 or more adenomas of any size, 1 or more large adenomas 1 cm, or 1 or more adenomas with villous architecture or highgrade dysplasia.
12 months
Adenoma per positive patient (APP)
Tidsramme: 12 months
The mean number of adenoma per positive patient
12 months
Quality of Bowel Preparation
Tidsramme: 12 months
The Boston Bowel Preparation Scale (BBPS): cleanliness of each part of the colon: 0=unprepared colon segment with mucosa not seen because of solid stool that cannot be cleared; 1=portion of mucosa of the colon segment seen, but other areas of the colon segment not well seen because of staining, residual stool, and/or opaque liquid; 2=minor amount of residual staining, small fragments of stool and/or opaque liquid, but mucosa of colon segment seen well; 3=entire mucosa of colon segment seen well with no residual staining, small fragments of stool, or opaque liquid.
12 months
Complication rate
Tidsramme: 12 months
Bleeding, perforation and others
12 months
Pain Scores on the Visual Analog Scale compared with previous colonoscopy
Tidsramme: 12 months
0 = no pain, to 10 = most severe pain
12 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Air Force Military Medical University, China

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. august 2016

Primær færdiggørelse (Forventet)

1. august 2017

Studieafslutning (Forventet)

1. august 2017

Datoer for studieregistrering

Først indsendt

19. august 2016

Først indsendt, der opfyldte QC-kriterier

25. august 2016

Først opslået (Skøn)

26. august 2016

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

26. august 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. august 2016

Sidst verificeret

1. august 2016

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • KY20162059-2

Plan for individuelle deltagerdata (IPD)

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UBESLUTET

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