Comparing Argon Plasma Coagulation and Endoscopic Mucosal Resection for Treating Small Gastric Adenomas with Low-Grade Dysplasia

What this Trial Is About

Gastric adenomas with low-grade dysplasia LGD are precancerous stomach lesions with a lower risk of progressing to cancer compared to high-grade dysplasia. This trial aims to compare two common endoscopic treatments, argon plasma coagulation APC and endoscopic mucosal resection EMR, to see if APC is as effective as EMR in preventing local recurrence of these small lesions measuring 1 cm or less. The study addresses current uncertainties and differing international guidelines on managing these lesions. Participants will be randomly assigned to receive either APC, which uses ionized argon gas to coagulate tissue without cutting, or EMR, which involves lifting and cutting out the lesion. EMR allows detailed pathological examination but may take longer and have more complications, while APC is simpler, quicker, and usually less invasive but lacks tissue for pathology. After treatment, all participants receive standard medical care and are monitored for any complications. Participants will return for follow-up endoscopies at 3 and 12 months to check the treated area and take biopsies if needed to detect recurrence. Researchers will record the local recurrence rate at 12 months as the main outcome, along with procedure-related complications like bleeding or perforation, procedure time, and recovery experience. The trial will provide important evidence to guide treatment choices for patients with small gastric adenomas.

Argon Plasma Coagulation Versus Endoscopic Mucosal Resection for Gastric Adenoma (CLER-GA)