Clinical trial Recruiting at 1 site Interventional Ages 18 and up

Comparing two methods for removing large colorectal adenomas

Official title: Cold Snare Endoscopic Mucosal Resection vs Cold Snare Endoscopic Mucosal Resection With Adjuvant Thermal Therapy to Resection Margins - A Randomised Controlled Trial

Run by Western Sydney Local Health District · NCT05041478 · Data updated 2026-11-12

This study is testing whether a new method that combines two techniques for removing large colorectal adenomas during colonoscopy works better than using just one of the techniques alone for patients with these types of growths.

Quick facts

Study typeInterventional
Ages18 Years and up
SexAll
Enrollment300 (estimated)
SponsorWestern Sydney Local Health District
Academic / other
Locations1 site (Westmead, New South Wales)
StatusRecruiting
StartedSeptember 19, 2023
Main results expectedOctober 1, 2028
Study endsOctober 1, 2028
Registry record updatedMarch 27, 2025
Trial IDNCT05041478 on ClinicalTrials.gov

Is this trial a fit for you?

Likely a good fit

Ideal candidates are adults over 18 years old with specific types of laterally spreading adenomas located in the colon or rectum.

Probably not a fit

Patients with bleeding disorders, pregnancy, or those with certain types of lesions or concurrent colorectal cancer may not benefit from this study.

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial is a randomized controlled trial that compares cold snare endoscopic mucosal resection (EMR) with cold snare EMR combined with margin snare tip soft coagulation (STSC) for the complete resection of 15-40mm lateral-spreading adenomas. The study aims to evaluate the safety and efficacy of these two techniques, focusing on complete resection rates and adenoma recurrence. Participants will be patients undergoing colonoscopy who have specific types of adenomas, and the trial will assess the outcomes of the different intervention methods. The hypothesis is that the combination of cold snare EMR with STSC will yield better results than cold snare EMR alone.

Why it matters

Potential benefit: If successful, this study could lead to improved safety and efficacy in the removal of large colorectal adenomas, reducing recurrence rates.

How similar studies have gone: While conventional EMR has been well-established, this specific comparison of cold snare EMR with and without STSC is novel and has not been extensively tested in prior studies.

Who can join: the full rules

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Any patient undergoing colonoscopy who is older than 18 years of age, has a written consent for trial participation and has at least one laterally spreading lesion meeting the following description:
* Localisation in the colon or rectum
* Benign adenomatous surface features (Kudo III / IV, Japan NBI Expert Team (JNET) 2a)
* Granular or non-granular topography
* Paris classification 0-IIa/IIb +/- Is
* If present, sessile component may be no greater than 10mm in size.
* Polyp size ranging from 15 to 40mm

Exclusion Criteria:

* Current use of antiplatelet (excluding aspirin) or anticoagulants which have not appropriately been interrupted according to the guidelines.
* Known bleeding disorder or coagulopathy.
* Pregnancy
* History of inflammatory bowel disease
* Previously attempted or otherwise non-lifting lesions
* Endoscopic features suggestive of submucosal invasion (Kudo Vi/n, JNET 2b / 3) or concurrent colorectal cancer
* Lesions involving the ileocaecal valve (ICV), appendiceal oriface or anorectal junction (ARJ)

Where it's running

  • Westmead Endoscopy Unit
    Westmead, New South Wales, Australia
    Recruiting

Study contacts

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How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.