Is ORISE Gel an effective and feasible submucosal injecting solution during endoscopic resection of large colorectal polyps.
Endoscopic resection of large colonic polyps is preferred over Surgical resections due to lower morbidity and preservation of the colon and its functions. The use of submucosal injection is essential for a successful resection (EMR/ ESD). Injection of fluid into the submucosa cushions and isolates the tissue just before capture of the target lesion with a snare, thereby reducing thermal injury and the risk of perforation during EMR. ESD requires a long period of submucosal dissection and that involves multiple injections to maintain the submucosal cushion; without which the risk of perforation increases. A mixture of normal saline solution + epinephrine and blue dye like indigo carmine is the commonly used injecting solution. However, Saline dissipates very quickly leading to frequent and multiple injections. This leads to longer procedure time. Studies have demonstrated long-lasting effects of colloids when injected in the submucosal space. ORISE gel is a newly licensed injecting solution which contains a poloxamer agent leading to longer lasting submucosal cushion effect. Multicentre prospective observational cohort study Primary Objective : Primary Objective To evaluate the technical feasibility, effectiveness \& safety of the ORISE gel as an injecting solution on its own during endoscopic resection of colorectal polyps (ability to start and finish the resection with ORISE). Secondary Objective : To identify Polyp Resection Time (PRT) and the amount of ORISE gel used during resection of large colorectal polyps.
Study Type
OBSERVATIONAL
Enrollment
133
To establish if ORISE Gel an effective and feasible submucosal injecting solution during endoscopic resection of large colorectal polyps
Humaitas Research Hospital
Milan, Italy
Portsmouth Hospital NHS Trust
Portsmouth, Hampshire, United Kingdom
Leeds General Infirmary
Leeds, United Kingdom
Kings College Hospital
London, United Kingdom
Feasability
Ease of use, rated on a 5-point visual analog scale for: very easy, easy, neutral, difficult and very difficult.
Time frame: 1 year
Effectiveness
Number of patients where alternatives to ORISE gel had to be used to complete the procedure
Time frame: 1 year
Safety - Presence of Muscle fibers in the resected specimen
Presence of Muscle fibers in the resected specimen
Time frame: 1 year
Safety - Complications
Complications: Perforationpost polypectomy syndrome, Intra procedural bleeding, post procedural
Time frame: 1 year
Total injected volume per lesion size
Total injected volume per lesion size: calculated by dividing the injected volume needed to complete the EMR procedure (in mL) by the lesion size (in mm2).
Time frame: 1 year
Sydney Resection Quotient
Sydney Resection Quotient: calculated by dividing the lesion size (in mm2) by the number of resections required to remove the lesion
Time frame: 1 year
Feasability
Polyp Resection Time
Time frame: 1 year
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John Radcliffe Hospital
Oxford, United Kingdom