Confocal Laser Endomicrospy in Colonic Diverticular Disease

NCT ID: NCT04173182

Last Updated: 2022-03-31

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

COMPLETED

Total Enrollment

63 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-11-01

Study Completion Date

2021-03-01

Brief Summary

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Confocal laser endomicroscopy detects inflammatory markers undetectable during high definition endoscopy. The investigators aimed to evaluate the role of peridiverticular and colonic mucosa inflammation in the prediction of the complicated diverticular disease using confocal laser endomicroscopy evaluation in the peridiverticular area in consecutive patients.

Detailed Description

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Diverticular disease of the colon is a prevalent condition in the western hemisphere. Currently there is an endoscopic classification system for classifying diverticular disease; however, white light endoscopic fails to accurately detect inflammation.

Confocal laser endomicroscopy offers a real-time, in-vivo evaluation of the colonic mucosa, with an adequate correlation to histological findings. The investigators aimed to evaluate the role of peridiverticular and colonic mucosa inflammation in the prediction of complicated diverticular disease.

Conditions

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Diverticular Disease Diverticulitis Diverticula

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Inflammation on pCLE

Patients with inflammatory findings in the peridiverticular and colonic mucosa (crypt fusion and distortion, bright epithelium, and dilated-prominent branching vessels)

Probe-based confocal laser endomicroscopy evaluation

Intervention Type DIAGNOSTIC_TEST

Colonoscopy with confocal laser endomicroscopy evaluation of the peridiverticular and colonic mucosa on patients with diverticular disease

No inflammation on pCLE

Patients with normal findings on pCLE evaluation of the peridiverticular and colonic mucosa (absence of inflammation)

Probe-based confocal laser endomicroscopy evaluation

Intervention Type DIAGNOSTIC_TEST

Colonoscopy with confocal laser endomicroscopy evaluation of the peridiverticular and colonic mucosa on patients with diverticular disease

Interventions

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Probe-based confocal laser endomicroscopy evaluation

Colonoscopy with confocal laser endomicroscopy evaluation of the peridiverticular and colonic mucosa on patients with diverticular disease

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Above 18 years old
* Writeen informed consent provided.
* Endoscopic visualization of diverticular disease during colonoscopy.
* Adequate bowel preparation BBPS \>2 in each colon segment

Exclusion Criteria

* Under 18 years old.
* Refuse to sign written informed consent.
* Pregnancy or nursing.
* Previous colorectal surgery
* History of colorectal cancer
* Known allergy to fluorscein
* Uncontrolled coagulopathy
* History of complicated diverticular disease
* Patients with inflammatory bowel disease
* Patients with severe comorbidities: kidney and liver failure
* NSAIDs and antibiotics two weeks prior enrollment
* Historyh of alcohol or drug abuse
* Patients with severe mental illness
* Patients with incomplete evaluation of the colon
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto Ecuatoriano de Enfermedades Digestivas

OTHER

Sponsor Role lead

Responsible Party

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Carlos Robles-Medranda

Head of the Endoscopy Division

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Carlos Robles-Medranda

Role: PRINCIPAL_INVESTIGATOR

Ecuadorian Institute of Digestive Diseases

Locations

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Ecuadorian Institute of Digestive Diseases

Guayaquil, Guayas, Ecuador

Site Status

Countries

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Ecuador

References

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Tursi A, Brandimarte G, Di Mario F, Andreoli A, Annunziata ML, Astegiano M, Bianco MA, Buri L, Cammarota G, Capezzuto E, Chilovi F, Cianci M, Conigliaro R, Del Favero G, Di Cesare L, Di Fonzo M, Elisei W, Faggiani R, Farroni F, Forti G, Germana B, Giorgetti GM, Giovannone M, Lecca PG, Loperfido S, Marmo R, Morucci P, Occhigrossi G, Penna A, Rossi AF, Spadaccini A, Zampaletta C, Zilli M, Zullo A, Scarpignato C, Picchio M. Development and validation of an endoscopic classification of diverticular disease of the colon: the DICA classification. Dig Dis. 2015;33(1):68-76. doi: 10.1159/000366039. Epub 2014 Dec 17.

Reference Type BACKGROUND
PMID: 25531499 (View on PubMed)

Tursi A, Brandimarte G, di Mario F, Nardone G, Scarpignato C, Picchio M, Elisei W; DICA Italian Group. The "DICA" endoscopic classification for diverticular disease of the colon shows a significant interobserver agreement among community endoscopists. J Gastrointestin Liver Dis. 2019 Mar;28(1):23-27. doi: 10.15403/jgld.2014.1121.281.dic.

Reference Type BACKGROUND
PMID: 30851168 (View on PubMed)

Tursi A, Elisei W, Picchio M, Nasi G, Mastromatteo AM, Di Mario F, Di Rosa E, Brandimarte MA, Brandimarte G. Impact of diverticular inflammation and complication assessment classification on the burden of medical therapies in preventing diverticular disease complications in Italy. Ann Transl Med. 2017 Aug;5(16):320. doi: 10.21037/atm.2017.06.39.

Reference Type BACKGROUND
PMID: 28861417 (View on PubMed)

Tursi A, Brandimarte G, Di Mario F, Annunziata ML, Bafutto M, Bianco MA, Colucci R, Conigliaro R, Danese S, De Bastiani R, Elisei W, Escalante R, Faggiani R, Ferrini L, Forti G, Latella G, Graziani MG, Oliveira EC, Papa A, Penna A, Portincasa P, Soreide K, Spadaccini A, Usai P, Bonovas S, Scarpignato C, Picchio M; DICA Collaborative Group: Luigi Di Cesare; Lecca PG, Zampaletta C, Cassieri C, Damiani A, Desserud KF, Fiorella S, Landi R, Goni E, Lai MA, Pigo F, Rotondano G, Schiaccianoce G. Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study. United European Gastroenterol J. 2016 Aug;4(4):604-13. doi: 10.1177/2050640615617636. Epub 2015 Nov 13.

Reference Type BACKGROUND
PMID: 27536372 (View on PubMed)

Other Identifiers

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PCLEDD

Identifier Type: -

Identifier Source: org_study_id

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