Adenoma

Researchers are studying adrenal tumor removal surgeries using a high-definition 3D laparoscopic system to improve outcomes compared to traditional 2D laparoscopy. This observational study explores the benefits of using 3D imaging, which offers better depth perception and spatial orientation, potentially reducing errors, fatigue, and operating time during adrenalectomies. The study focuses on both benign and malignant adrenal tumors. The surgery uses a 3D laparoscopic system where all operating room personnel wear polarized glasses to see stereoscopic images. Dissection is performed with a hybrid energy device called Thunderbeat. The study observes patients who underwent unilateral 3D laparoscopic adrenalectomy between 2013 and 2033, without comparing to other surgical approaches. Participants have their surgical outcomes monitored up to 30 days after surgery, including complication rates and length of hospital stay. Researchers also evaluate factors like bleeding, operative time, use of drainage, and differences in morbidity related to obesity, previous surgeries, patient age, anesthesia risk scores, tumor size, diagnosis, and tumor side. The study collects detailed data to understand how 3D laparoscopy affects adrenalectomy results over time.

Colorectal cancer is a common and serious disease that often develops from precursor growths called adenomatous polyps. This study evaluates the long-term effects of berberine hydrochloride, a drug previously shown to reduce recurrence of these polyps after removal. Researchers aim to see if the protective effects of berberine continue for up to six years after patients stop taking the medication. The study observes patients who were part of an earlier trial where they received either berberine or a placebo. It compares the recurrence rates of colorectal adenomas and other types of polyps at multiple intervals within the first year, between one and three years, and between three and six years after stopping the drug. This retrospective follow-up helps assess berberines long-term preventive effects. Participants will be monitored through medical records to track the recurrence of colorectal adenomas and other polyps over six years. Researchers will analyze outcomes such as the rate of traditional adenoma recurrence and the incidence of hyperplastic and serrated polyps. This study provides important information about the lasting impact of berberine on colorectal polyp recurrence after endoscopic removal.

Researchers are evaluating the use of Gallium-68-DOTATATE PETMRI in patients with somatostatin receptor-positive SSTR-positive central nervous system CNS tumors, mainly focusing on meningioma but also including other tumor types such as esthesioneuroblastoma, hemangioblastoma, medulloblastoma, paraganglioma, pituitary adenoma, and SSTR-positive systemic cancers metastatic to the brain. The study aims to assess the diagnostic usefulness of this imaging technique, especially in distinguishing tumor recurrence from post-treatment changes, with a particular interest in cases where tumor location limits surgical removal or where patients have higher-grade disease or previous radiation treatment. This is a Phase 4 interventional study sponsored by Weill Medical College of Cornell University.

Researchers are evaluating the use of a PET isotope called Fluorine-18 18F attached to Choline in people suspected of having parathyroid adenoma who have negative or unclear results from the standard 99mTc Sestamibi SPECTCT scan. The study focuses on detecting parathyroid adenomas using this new imaging technique in a single-center, single-arm trial. Participants receive an intravenous injection of 18F Fluorocholine about 5 mCi with a 20% margin, followed 45 to 60 minutes later by a low dose CT scan from the skull base to mid-thighs. This is immediately followed by a static PET emission scan over the same area, aiming to locate parathyroid adenomas more effectively than the standard scan. During the study, participants undergo the PETCT imaging process once, and researchers measure the number of lesions detected within an hour after the scan. Safety is monitored through blood tests and heart monitoring prior to the scan. The total participation time is brief and focused on imaging and related assessments.

This clinical trial is investigating sedation methods during colonoscopic polypectomy procedures. It aims to compare the effects of remimazolam besylate combined with sufentanyl versus propofol combined with sufentanyl on circulatory and respiratory stability. The study also evaluates the incidence of hypotension and respiratory depression, as well as the overall sedation success and recovery times in adult patients. Participants are randomly assigned to one of two groups a study group receiving remimazolam besylate and sufentanyl, and a control group receiving propofol and sufentanyl. In both groups, patients receive intravenous sufentanyl followed by the sedative drug, with doses tailored to achieve the desired sedation level assessed by BIS monitoring and the Modified Observers Assessment of Alertness and Sedation Scale MOAAS. Continuous oxygen flow and non-invasive monitoring are applied during the procedure. Throughout the study, patients are monitored for vital signs including oxygen saturation, heart rate, blood pressure, and respiratory rate before, during, and after the procedure. Sedation depth, time to adequate sedation, full alertness, and recovery readiness are measured. Researchers also track drug doses, procedure duration, infusion volumes, and post-procedure symptoms such as pain, nausea, and vomiting. The total observation period per participant spans approximately 2 to 4 hours.

This research aims to describe the clinical, histological, and radiological features of rare primary liver cancers. It focuses on collecting tumor and blood samples to better understand these cancers and to evaluate how well treatments used in real-world practice work, with the goal of identifying the best treatment sequences. The study serves as a foundation for future research to find new molecular and imaging biomarkers that could improve diagnosis and prognosis. The study is observational and retrospective, meaning it reviews past cases from multiple centers in France. It collects biological samples and clinical data from patients diagnosed with rare primary liver cancers after January 2018. The study evaluates treatments patients have received in clinical practice without assigning any new treatments or interventions. Participants data, including clinical characteristics, tumor biology, and imaging, will be reviewed for up to five years from diagnosis. Researchers will measure outcomes such as recurrence-free survival for patients without metastases, progression-free survival for those with metastases, and overall survival. The study includes both living patients who consent to participate and deceased patients, aiming to gather comprehensive information to support future translational studies.

Colorectal cancer can often be prevented by removing pre-malignant polyps during colonoscopy. Large non-pedunculated colorectal polyps LNPCPs measuring 20mm or more need careful evaluation because the presence of submucosal invasive cancer SMI determines if endoscopic treatment alone is enough or if surgery is required. Existing classification methods for detecting SMI are complex and underused in many hospitals, so a simpler approach is needed. A new web-based clinical decision support tool has been developed using common endoscopic features like demarcated areas, polyp size, Paris classification, location, and granularity to help identify SMI in LNPCPs. This tool uses standard imaging available in most endoscopy units. The study is a prospective multicenter trial across several countries, where endoscopists of varying experience assess sets of 10 large polyps using the tool before and after randomized educational interventions, including a short instructional video or a longer interactive session. A follow-up assessment at 3 months checks how well the learning is retained. Participants include endoscopists who assess live colonoscopies with the tool and create standardized videos of lesions for expert comparison. Various accuracy and agreement measures are recorded throughout the study, alongside histology results of resected polyps. The study tracks performance before training, immediately after, and three months later, lasting up to 48 months. Safety and data quality are monitored continuously, and expert opinion serves as the reference standard for assessment accuracy.

Researchers are evaluating a new oral synbiotic formula called SMT04 to see if it can reduce the recurrence of advanced adenomas and related bacterial gene markers in people who have had colorectal advanced neoplasia removed. The study is a multicenter, double-blinded randomized controlled trial focused on colorectal cancer and its precancerous lesions, exploring how gut microbiome changes may influence disease progression and recurrence. The trial seeks to understand if SMT04 can sustain long-term benefits in lowering harmful bacterial markers linked to colorectal neoplasia. Participants will be randomly assigned to receive either the SMT04 synbiotic formula, which combines probiotics and heat-resistant prebiotics, or an active placebo containing a small amount of vitamin C and inert starch filler with matching appearance and flavor. The trial includes a control group receiving the placebo to compare effects. The SMT04 formula has previously been shown to increase beneficial Bifidobacterium species and reduce certain bacterial gene markers over weeks 2 to 12, but its long-term impact is still being studied. During the year-long study, participants will undergo monitoring to detect any recurrence of advanced colorectal neoplasia through colonoscopies and bacterial gene marker measurements. Researchers will track the incidence and number of recurrent adenomas and advanced neoplasia, as well as changes in bacterial gene markers and their correlation with disease recurrence. The primary outcome is the incidence of recurrent advanced colorectal neoplasia at one year. The study involves regular assessments, including colonoscopy quality checks and histopathological confirmation, to ensure thorough evaluation of treatment effects.

Researchers are evaluating the accuracy of a new artificial intelligence system called EndoAIM for measuring colorectal polyp size during real-time endoscopy. Accurate measurement of polyp size, especially at the 10 mm threshold, is important for assessing the risk of advanced neoplasia and colorectal cancer, as well as deciding the best removal method. Current visual estimates by doctors can be inaccurate, leading to risks of delayed diagnosis or unnecessary procedures. In this study, EndoAIM will be used during the withdrawal phase of colonoscopy procedures to automatically estimate polyp diameters. This device aims to improve measurement accuracy compared to visual estimates or non-calibrated tools. The study focuses on real patients undergoing colonoscopy, assessing EndoAIMs performance in real-time clinical settings. Participants will undergo colonoscopy with EndoAIM used to measure polyps during the procedure. Researchers will compare measurement accuracy at 10 mm and 5 mm thresholds and evaluate the correctness of size estimations. The primary outcome is the difference in percentage accuracy at the 10 mm threshold during colonoscopy. Secondary outcomes include accuracy at the 5 mm threshold and the proportion of polyps and subjects measured correctly. The study includes adults aged 18 and older and involves monitoring during the colonoscopy procedure.

This clinical trial investigates the safety and recovery benefits of tubeless laparoscopic adrenalectomy in patients undergoing adrenal gland removal surgery. The study aims to answer whether avoiding drainage tubes after surgery helps patients recover more quickly, focusing on pain, the time to first get out of bed, and the recovery of intestinal function. It is a prospective, single-center, randomized controlled study enrolling 200 patients who need laparoscopic adrenalectomy. Participants are randomly assigned to one of two groups one group receives surgery without drainage tubes tubeless group, and the other group has drainage tubes placed after surgery drainage group. The study compares outcomes such as pain scores, blood tests, and recovery indicators between these groups. Follow-up includes adrenal ultrasounds at one and six months post-surgery to monitor recovery and safety. During the study, participants will have blood tests and assessments of pain, time to mobilization, and intestinal function for the first three days after surgery. Researchers will also monitor for complications like fever and wound infections. Follow-up ultrasound exams at one and six months will help evaluate longer-term recovery. The trial uses block randomization and collects data to assess whether tubeless surgery promotes faster and safer recovery after adrenalectomy.