Patients who have provided informed consented and are scheduled to undergo endoscopic mucosal resection (EMR) of lesions 15mm and larger will be randomized to STSC (80 W, Effect 5) vs APC (preferred settings) vs No Treatment of the perimeter of the EMR site.
Data regarding polyp morphology, location \& shape will be recorded in addition to procedure and treatment length. Injection fluid use and clipping will also be recorded in addition to any procedural complications. All randomized subjects will receive a 30-day post procedure follow-up phone call and be scheduled, as per the standard of care, to receive a standard follow-up colonoscopy procedure after the initial procedure. The investigators will measure the rate of recurrence by endoscopic visualization of the EMR site at the first follow-up using endoscopic magnification and electronic chromoendoscopy, as well as systematic biopsy of the scars.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
384
APC will be applied to the perimeter of the resection site
STSC will be applied to the perimeter of the resection site
Sibley Memorial Hospital
Washington D.C., District of Columbia, United States
AdventHealth Orlando
Orlando, Florida, United States
Indiana University Health University Hospital
Indianapolis, Indiana, United States
Recurrence
The recurrence rate of adenomas at the site of any qualifying, previously resected lesions will be measured at the first follow-up colonoscopy
Time frame: 1 day
Types of Recurrences
Description of whether recurrence was visible during the follow-up procedure and confirmed by pathology, visible during the follow-up procedure but not confirmed by pathology, or not visible during the follow-up procedure but confirmed by pathology of biopsies taken.
Time frame: 1 day
Time
The time it takes to apply each respective treatment (APC or STSC) on the day of procedure
Time frame: 1 day
Complications
To look at the number of complications for each randomization arm as assessed through a 30 day follow-up period
Time frame: 1 day
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