Polyps
Conditions
Brief summary
The development of a standardised imaging protocol to detect post endoscopic mucosal resection (EMR) recurrence or residual adenoma through the comparison of biopsies of the post EMR scar with endoscopic findings.
Detailed description
Removal of colonic polyps reduces colon cancer and although most polyps found are small, removal of large polyps can now be safely and effectively removed with wide field EMR. Residual polyp tissue is found at follow up colonoscopy in approximately 15% of cases however and remains a focus of attempts to improve EMR efficacy. All patients undergoing surveillance colonoscopy after EMR at Westmead Hospital Endoscopy unit will have steps of assessment and therapy of the scar recorded. Data will be entered into the large prospective audit database and also analysed separately. Data will be stored in coded format. The individual steps and the outcome of the scar interrogation and therapy will also be assessed and analysed. It is expected that these results will help guide the optimal approach to assessment and confirm the efficacy of therapy of recurrence further aiding the endoscopic approach to large colonic polyps.
Interventions
None listed
Sponsors
Western Sydney Local Health District
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing surveillance colonoscopy of a previously resected large sessile colonic polyp or laterally spreading tumour ≥20mm in size. * Age \> 18 years * Able to give informed consent to involvement in the clinical study
Exclusion criteria
* Unable to provide informed consent for involvement
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of post-EMR recurrence | one year | Presence of post-EMR recurrence |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Scar size | one year | Scar size (maximum dimension) |
| Presence of post EMR scar with clip artifact | one year | Presence of post EMR scar with clip artifact, recognized as one or more nodule within the scar with a normal pit pattern |
| Number of sites of recurrence | one year | Number of sites of recurrence (unifocal, 2 sites, 3 or more sites) |
| Histological characteristics of post-EMR scar biopsies | one year | — |
| Morphology of recurrence | one year | Morphology of recurrence (flat or elevated) |
| Kudo pit pattern assessment | one year | Kudo pit pattern and whether the pit pattern of recurrence is only seen with NBI |
| NICE classification | one year | As recurrence is diminutive the NICE classification is also applied and so the NBI appearance of recurrence (darker or lighter than the scar) is noted. |
| Location of recurrence | one year | Location of recurrence (edge of the scar, within the scar or both) |
Countries
Australia
Outcome results
None listed