Comparing Early Versus Elective Colonoscopy

NCT ID: NCT03098173

Last Updated: 2019-11-08

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

162 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-29

Study Completion Date

2019-01-04

Brief Summary

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This multi-center, randomized controlled trial study is planned to include 162 outpatients with onset of acute lower gastrointestinal bleeding to compare the rate of identification of stigmata of recent hemorrhage (SRH), and other clinical outcomes, including the 30-day rebleeding rate, between 'early' colonoscopy and 'elective' colonoscopy.

Detailed Description

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All patients will receive early colonoscopy or elective colonoscopy, but they do so by different timing.

Early colonoscopy will be performed within 24 h of the initial visit. Elective colonoscopy will be performed between 24 and 96 h after the initial visit.

Conditions

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Acute Lower Gastrointestinal Bleeding

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel, randomized, superiority trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Early colonoscopy

Performance of prepared colonoscopy within 24 h of arrival

Group Type EXPERIMENTAL

Early colonoscopy

Intervention Type PROCEDURE

Performance of prepared colonoscopy within 24 h of arrival

Elective colonoscopy

Performance of prepared colonoscopy between 24 and 96 h after arrival

Group Type ACTIVE_COMPARATOR

Elective colonoscopy

Intervention Type PROCEDURE

Performance of prepared colonoscopy between 24 and 96 h after arrival

Interventions

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Early colonoscopy

Performance of prepared colonoscopy within 24 h of arrival

Intervention Type PROCEDURE

Elective colonoscopy

Performance of prepared colonoscopy between 24 and 96 h after arrival

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Males or females aged ≥ 20 years, presenting with moderate-to-severe hematochezia or melena within 24 h of arrival, defined as (i) more than three occurrences of hematochezia within 8 h, (ii) hemorrhagic shock, or (iii) requiring transfusion.
2. Provision of signed and dated informed consent form.
3. Stated willingness to comply with all study procedures and availability for the duration of the study.

Exclusion Criteria

An individual who meets any of the following criteria will be excluded from participation in this study:

1. Patients with hematemesis, black vomiting, or melena.
2. Patients with upper gastrointestinal bleeding, diagnosed by nasogastric tube or upper endoscopy.
3. Patients who have impossible consumed the oral bowel preparation solution.
4. Patients who have undergone computed tomography.
5. Patients who have been diagnosed with peptic ulcer diseases within the previous 10 days.
6. Ulcerative colitis or Crohn's disease patients.
7. Patients who have undergone abdominal surgery within the previous 10 days.
8. Patients who have undergone polypectomy, endoscopic mucosal resection, or endoscopic submucosal dissection of the lower gastrointestinal tract within the previous 10 days.
9. Patients with suspected perforation or peritonitis.
10. Patients with suspected intestinal obstruction.
11. Patients with hemorrhagic shock refractory to infusion or blood transfusion.
12. Patients who have undergone total colectomy.
13. Patients with suspected disseminated intravascular coagulation.
14. Patients with end-stage malignant disease.
15. Patients with severe cardiac failure.
16. Patients with active thrombosis.
17. Patients with severe respiratory failure.
18. Pregnant patients.
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tokyo University

OTHER

Sponsor Role lead

Responsible Party

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Atsuo Yamada

Department of Gastroenterology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Atsuo Yamada, MD

Role: STUDY_DIRECTOR

Tokyo University

Locations

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Aichi Cancer Center Hospital

Nagoya, Aichi-ken, Japan

Site Status

Hirosaki University Hospital

Hirosaki-shi, Aomori, Japan

Site Status

National Center for Global Health and Medicine kohnodai hospital

Ichikawa-shi, Chiba, Japan

Site Status

Fukui prefectural hospital

Fukui-shi, Fukui, Japan

Site Status

National Hospital Organization Hakodate Hospital

Hakodate-shi, Hokkaido, Japan

Site Status

Otaru Ekisaikai Hospital

Otaru-shi, Hokkaido, Japan

Site Status

Tonan Hospital

Sapporo, Hokkaido, Japan

Site Status

Ishikawa prefectural central hospital

Kanazawa, Ishikawa-ken, Japan

Site Status

Nagasaki Harbor Medical Center City Hospital

Nagasaki, Nagasaki, Japan

Site Status

Japan Community Healthcare Organization Osaka Hospital

Fukushima-shi, Osaka, Japan

Site Status

Toyonaka Municipal Hospital

Toyonaka-shi, Osaka, Japan

Site Status

The University of Tokyo

Bunkyo-ku, Tokyo, Japan

Site Status

St. Luke's International Hospital

Chuo-ku, Tokyo, Japan

Site Status

National Center for Global Health and Medicine center hospital

Shinjuku-ku, Tokyo, Japan

Site Status

Shuto General Hospital

Yanai-shi, Yamaguchi, Japan

Site Status

Countries

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Japan

References

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Niikura R, Nagata N, Doyama H, Ota R, Ishii N, Mabe K, Nishida T, Hikichi T, Sumiyama K, Nishikawa J, Uraoka T, Kiyotoki S, Fujishiro M, Koike K. Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan: A multicenter questionnaire study. World J Gastrointest Endosc. 2016 Dec 16;8(20):785-794. doi: 10.4253/wjge.v8.i20.785.

Reference Type BACKGROUND
PMID: 28042393 (View on PubMed)

Niikura R, Nagata N, Yamada A, Honda T, Hasatani K, Ishii N, Shiratori Y, Doyama H, Nishida T, Sumiyoshi T, Fujita T, Kiyotoki S, Yada T, Yamamoto K, Shinozaki T, Takata M, Mikami T, Mabe K, Hara K, Fujishiro M, Koike K. Efficacy and Safety of Early vs Elective Colonoscopy for Acute Lower Gastrointestinal Bleeding. Gastroenterology. 2020 Jan;158(1):168-175.e6. doi: 10.1053/j.gastro.2019.09.010. Epub 2019 Sep 26.

Reference Type DERIVED
PMID: 31563627 (View on PubMed)

Niikura R, Nagata N, Yamada A, Doyama H, Shiratori Y, Nishida T, Kiyotoki S, Yada T, Fujita T, Sumiyoshi T, Hasatani K, Mikami T, Honda T, Mabe K, Hara K, Yamamoto K, Takeda M, Takata M, Tanaka M, Shinozaki T, Fujishiro M, Koike K. A multicenter, randomized controlled trial comparing the identification rate of stigmata of recent hemorrhage and rebleeding rate between early and elective colonoscopy in outpatient-onset acute lower gastrointestinal bleeding: study protocol for a randomized controlled trial. Trials. 2018 Apr 3;19(1):214. doi: 10.1186/s13063-018-2558-y.

Reference Type DERIVED
PMID: 29615078 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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UMIN000021129

Identifier Type: OTHER

Identifier Source: secondary_id

P2015034-11Y

Identifier Type: -

Identifier Source: org_study_id

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