Esophageal Neoplasms
Conditions
Brief summary
The main purpose of this study will be to two-fold; firstly to determine whether the use of a Captivator tissue cassette has an effect on the preservation of tissue histology (minimizing artifactual curling) , and secondly to determine whether the use of a intraprocedural cassette is practical. The investigators believe that this will greatly aid in elucidating the best technique for optimizing performance of EMR for esophageal lesions.
Detailed description
As a result of the advances in endoscopic procedures, the detection of early stage esophageal carcinoma has increased. Endoscopic mucosal resection (EMR) is an innovative technique for removal of high grade intraepithelial neoplasia/dysplasia to prevent the progression of invasive carcinoma which occurs in about a third of patients. EMR involves the endoscopic therapeutic removal of the abnormal esophageal area(s) of tissue by snare or suction, aiming to include as much of the submucosal layer as possible, which is (are) then submitted for histopathological examination for pathological diagnosis and tumor staging. Compared with esophageal biopsy, this methodology reveals more advanced tumor stages in terms of grading and vertical infiltration in 10-20% of patients. Because of the importance of histopathologic diagnosis, the specimen should be pinned on a cork or styrofoam board to prevent curling and maintain the orientation, integrity of the size and shape, and fixed in an appropriate volume of 10% formalin. Unfortunately, specimens are often not pinned as EMR specimens can be difficult and time consuming to pin because of their thickness, hence the specimen integrity (size and shape) and orientation is compromised. Therefore the main purpose of this study will be to two-fold; firstly to determine whether the use of a Captivator tissue cassette has an effect on the preservation of tissue histology (minimizing artifactual curling) , and secondly to determine whether the use of a intraprocedural cassette is practical. The investigators believe that this will greatly aid in elucidating the best technique for optimizing performance of EMR for esophageal lesions.
Interventions
OTHERStandard of Care
The specimen will be processed following the College of American Pathology Standards.
DEVICECaptivator cassette
The Captivator tissue cassette has an effect on the preservation of tissue histology.
Sponsors
AdventHealth
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
SINGLE (Caregiver)
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients referred to Florida Hospital Endoscopy Unit for assessment of an esophageal lesion that require EMR * Age ≥ 19 years
Exclusion criteria
* Age \<19 years * Unable to safely undergo EMR for any reason * Coagulopathy (INR \>1.6, Thrombocytopenia with platelet count \<80,000/ml) * Unable to provide consent for any reason * Pregnancy (confirmed with Standard of Care urine pregnancy test for all women with child-bearing potential)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Histological quality of the EMR specimen obtained during the procedure will be analyzed and compared to cassette vs. no cassette for pathology review. | 1 year | 1\. Captivator tissue cassette vs. no cassette 1. Captivator tissue cassette with margin curling/artifact vs. Captivator tissue cassette without margin curling/artifact 2. No cassette with margin curling/artifact vs. no cassette without margin curling/artifact 3. Captivator tissue cassette with margin curling/artifact vs. No cassette with margin curling/artifact |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ease of use of the Captivator tissue cassette will be comparable to Standard of Care. | 1 year | Ease of use of the Captivator tissue cassette will be comparable in terms of handling the histologic specimen and will not add significant time to the intraprocedural or laboratory handling and processing. |
Countries
United States
Outcome results
None listed