NCT04015765Completed
Hybrid-APC Margin Ablation to Prevent Post EMR Adenoma Recurrence
Source: ClinicalTrials.gov · Last updated 8 Sept 2026
Brief summary (registry, in English)
Endoscopic Mucosal Resection (EMR) is the current standard for effective endoscopic resection of such colon adenomas. If resection is possible in one piece (so-called "en bloc" resection) then recurrence rates are low. However, most non-pedunculated polyps \>2 cm are removed in pieces ("piece-meal" resection) which leads to disease recurrence rates between 12-30%. In the March 2019 issue of Gastroenterology Bourke et al. presented that post-EMR ablation of the resection margins using soft coagulation with the tip of a resection snare reduces adenoma recurrence to 5% compared to 21% recurrence found in the control group. Hybrid Argon Plasma Coagulation (h-APC) combines an ablation technique (APC) with the option for submucosal saline injection using a high-pressure water jet. The technique allows to lift of dysplastic epithelium thus creating a safety cushion under the mucosa is lifted with a saline injection and then to ablate larger areas more thoroughly and with a higher energy setting, with a low risk for side effects or complications. The study hypothesis is that routine use of hybrid Argon Plasma Coagulation (h-APC) for ablation of the post-EMR resection margins and resection surface area will reduce post-EMR adenoma recurrence to 5% or lower.
- Status (registry)
- Completed
- Study type
- Interventional
- Enrollment
- 376 (actual)
- First submitted
- 4 Jul 2019
- Start date
- 26 Aug 2019
- Primary completion date
- 13 Dec 2024
- Lead sponsor
- Centre hospitalier de l'Université de Montréal (CHUM)
- Diseases
- Colorectal cancer
- NCT number
- NCT04015765
What you commit to
- Study type: Interventional
- Participants enrolled: 376
- From 26 Aug 2019 to the primary completion date, 13 Dec 2024
- 1 site in 1 country
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Prior treatment
- Previous partial EMR
- Patients who are receiving an emergency colonoscopy
- Need for ESD for complete resection prior to APC
Other illness
- Patients with inflammatory bowel disease
- Target sign or perforation during initial EMR
Lab values
- Patients with coagulopathy with an elevated INR ≥1.5, or platelets \<50
Other
- Patients with known (biopsy proven) invasive carcinoma in a potential study polyp
- Pedunculated polyps (as defined by Paris Classification type Ip or Isp)
- Patients with ulcerated depressed lesions (as defined by Paris Classification type III)
- Poor general health (ASA class\>3)
- Poor bowel preparation (Boston bowel prep score ≤2)
- Pregnancy and breast-feeding.
Who the study is looking for
- All Ethnicity and race
- Patient referred for endoscopic resection of all colorectal polyps non-pedunculated equal or greater 20 mm
- Written informed consent
Age in the registry: 18 years to 89 years · Sex: All · Does not accept healthy volunteers
Sites (1)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| Centre Hospitalier Universitaire de Montréal (CHUM) Coordinator of this site? Confirm its status | Montreal | Canada | Unknown status |
This page is information, not medical advice. Discuss any trial with your doctor.