Comparing Cold Snare Endoscopic Mucosal Resection Alone vs Cold Snare EMR with Additional Thermal Treatment to Polyp Edges for Removing 15-40mm Colorectal Polyps

What this Trial Is About

The trial investigates cold snare endoscopic mucosal resection EMR techniques for removing 15-40mm lateral-spreading adenomas in the colon or rectum. It compares standard cold snare EMR with cold snare EMR combined with adjuvant margin snare tip soft coagulation STSC. The study aims to assess whether adding STSC improves complete resection rates and reduces adenoma recurrence, addressing safety concerns related to cauterisation complications in conventional EMR. Participants undergo a colonoscopy where the lesion is raised using injected chromogelofusine solution. In one group, the lesion is removed using a stiff thin-wired snare followed by electrocautery treatment of the defect margins with STSC to ablate tissue. The other group receives the same removal procedure without the adjuvant thermal therapy. This randomized controlled trial evaluates these two procedures to compare their safety and effectiveness. During the study, researchers measure the complete resection rate one day after the procedure and adenoma recurrence rates at 4 to 6 months. They also monitor intra-procedural and post-procedural complications for 30 days. Participants provide written consent and are followed through trial visits, allowing detailed assessment of outcomes related to polyp removal and recovery. The study is sponsored by Western Sydney Local Health District and runs until October 2028.

Cold Snare Endoscopic Mucosal Resection (EMR) vs Cold EMR With Margin Snare Tip Soft Coagulation (STSC)