Does the Cap Increase the Finding of Polyps When Water Exchange Colonoscopy is Used

NCT ID: NCT03566615

Last Updated: 2022-10-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

1630 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-01

Study Completion Date

2023-01-31

Brief Summary

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This is a study to compare two different, but normally, used methods of colonoscopy in patients that require a routine or repeat colonoscopy. There will be three arms in this study: WE water control, water plus Cap-1, and water plus Cap-2. The patient will prepare himself/herself for the colonoscopy as per normal instructions and he/she will be given the information for the study at that time so that he/she can make a decision to participate in the study. The control method will use water instead of air inserted into the colon. The study method will use a new accessory, a cap that will fit onto the end of the colonoscope plus water during the procedure. This study will also confirm if using the cap method with water is a better way of detecting polyps in the colon and possibly cancer.

Detailed Description

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This will be a multi-site, multi-national, unblinded investigators, prospective Random Control Trial (RCT). Randomization (WE, WE Cap-1, WE Cap-2) will be based on computer generated random numbers placed inside opaque sealed envelopes. The envelope (in pre-arranged order) will be opened to reveal the code when the colonoscopist is ready to insert the endoscope to begin the examination. This will be a comparison of two different methods with three arms (WE, WE Cap-1, WE Cap-2) to see which one is better at detecting adenomas.

Patients who are willing to participate will sign an informed consent before starting the colonoscopy procedure. Separate parallel randomization will be set up at each site, stratified by investigator and type of colonoscopy (screening or surveillance). Mode of sedation will include unsedated (China, US West Los Angeles VA), minimally sedated (Taiwan), on demand sedation (Italy, Czech Republic, US West Los Angeles VA), conscious sedation (US Sacramento VA and Palo Alto VA) or full sedation with propofol (Taiwan). Randomization (prepared by statistics consultant) will be carried out by the method of random permuted block design (based on computer generated random numbers) with variable block sizes of 3 and 6. Gender will be used as a stratification factor.

Control Method: One arm of the study will include sedated/unsedated colonoscopy with water (WE) as the control method. Residual air in the colon will be removed and water will be infused to guide insertion through an airless lumen. Infused water will be removed by suction, along with residual fecal debris, predominantly during insertion.

Study method: The other two arms entail the addition of a simple commercially available accessory to the colonoscopy device: Cap -1 (Disposable Distal Attachment) or Cap-2, fitted to the colonoscope per manufacturer instruction. The two arms include sedated/unsedated colonoscopy with either a Cap-1 plus water or Cap-2 plus water.

Conditions

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Colonoscopy Polyp of Colon

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Water

Residual air in the colon will be removed, water will be infused to guide insertion through an airless lumen. Infused water will be removed by suction, along with residual fecal debris, predominantly during insertion.

Group Type ACTIVE_COMPARATOR

water

Intervention Type OTHER

using water instead of traditional air insufflation to help insertion

CAP-straight

A straight transparent cap was fitted to the colonoscope per manufacturer instruction.Residual air in the colon will be removed, water will be infused to guide insertion through an airless lumen. Infused water will be removed by suction, along with residual fecal debris, predominantly during insertion.

Group Type EXPERIMENTAL

CAP-straight

Intervention Type DEVICE

This study is to detect any differences in the detection rate of adenomas using straight caps that will be attached to the colonoscope and to compare it to the control method where no cap is used in the colonoscopy procedure.

water

Intervention Type OTHER

using water instead of traditional air insufflation to help insertion

CAP-daisy

A daisy cap transparent cap was fitted to the colonoscope per manufacturer instruction.Residual air in the colon will be removed, water will be infused to guide insertion through an airless lumen. Infused water will be removed by suction, along with residual fecal debris, predominantly during insertion.

Note:

IRB Approval date for the use of Endocuff at St. Barbara Hospital, Iglesias (CA), Italy, was obtained on 3/8/2017.

IRB Approval date for the use of Endocuff at Evergreen General Hospital, Taipei, Taiwan, was obtained on 3/18/2021.

Group Type EXPERIMENTAL

CAP-daisy

Intervention Type DEVICE

This study is to detect any differences in the detection rate of adenomas using daisy caps that will be attached to the colonoscope and to compare it to the control method where no cap is used in the colonoscopy procedure.

water

Intervention Type OTHER

using water instead of traditional air insufflation to help insertion

Interventions

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CAP-straight

This study is to detect any differences in the detection rate of adenomas using straight caps that will be attached to the colonoscope and to compare it to the control method where no cap is used in the colonoscopy procedure.

Intervention Type DEVICE

CAP-daisy

This study is to detect any differences in the detection rate of adenomas using daisy caps that will be attached to the colonoscope and to compare it to the control method where no cap is used in the colonoscopy procedure.

Intervention Type DEVICE

water

using water instead of traditional air insufflation to help insertion

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Male and female 50-75 yrs of age.
2. Positive screening for Fecal Immunochemical Test (FIT) or Fecal Occult Blood Test (FOBT).
3. Subjects willing to undergo routine screening and surveillance colonoscopy.

Exclusion Criteria

1. Patients who decline to provide informed consent.
2. Patients known to have colonic obstruction, inflammatory bowel disease, or active GI bleeding requiring interventions.
3. Patients know to have prior history of severe diverticulitis/diverticulosis.
Minimum Eligible Age

50 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of California, Los Angeles

OTHER

Sponsor Role collaborator

VA Greater Los Angeles Healthcare System

FED

Sponsor Role lead

Responsible Party

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Felix W. Leung

Site PI and Director of Study

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Felix W Leung, MD

Role: PRINCIPAL_INVESTIGATOR

VA Greater Los Angeles Healthcare System

Locations

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Sacramento VAMC, VA Northern California Healthcare System

Mather, California, United States

Site Status RECRUITING

Veterans Affairs Palo Alto Healthcare System

Palo Alto, California, United States

Site Status RECRUITING

Xijing Hospital of Digestive Diseases

Xi'an, , China

Site Status RECRUITING

St. Barbara Hospital

Iglesias, , Italy

Site Status COMPLETED

Dalin Tzu Chi General Hospital

Chiayi City, , Taiwan

Site Status RECRUITING

Hualien Tzu Chi Hospital

Hualien City, , Taiwan

Site Status RECRUITING

Evergreen General Hospital

Taipei, , Taiwan

Site Status RECRUITING

Countries

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United States China Italy Taiwan

Central Contacts

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Vivek Dixit, PhD

Role: CONTACT

818-895-9426

Felix W Leung, MD

Role: CONTACT

818-891-7711 ext. 32520

Facility Contacts

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Andrew Yen, MD

Role: primary

Joseph W Leung, MD

Role: backup

Shai Friedland, MD

Role: primary

Ramsey Cheung, MD

Role: backup

Yanglin Pan, MD

Role: primary

Yu-Hsi Hsieh, MD

Role: primary

Chi-Tan Hu, MD

Role: primary

Cheng Chiliang, MD

Role: primary

Other Identifiers

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ASGE 2016 International Award

Identifier Type: -

Identifier Source: org_study_id

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