Cold Atmospheric Plasma for the Endoscopic Treatment of Duodenal Polyps in Patients With Familial Adenomatous Polyposis

NCT ID: NCT06435533

Last Updated: 2024-05-30

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

RECRUITING

Clinical Phase

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-12-06

Study Completion Date

2025-03-02

Brief Summary

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The objective of this study is to investigate the feasibility for the treatment of precancerous peri-ampullary FAP polyps in the duodenum using low-thermal argonplasma.

Detailed Description

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Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited disorder, which results from a germ line mutation in the APC (adenomatous polyposis coli) gene. FAP is characterized by the formation of very high number of colorectal adenomatous polyps which could cause the development of colorectal cancer in the 5th decade of life. After colon surgery patients are still at risk of developing upper GI cancer e.g. in the duodenum. Because of the continuing risk for the development of duodenal cancer, regular endoscopic surveillance is recommended for these patients.

In this study a new APC modality (Precise mode E1) applied for the remission of FAP polyps during routine endoscopic surveillance is suggested. Argonplasma coagulation (APC) is widely used for the ablation and coagulation of superficial lesions in the GI tract. The application of high thermal tissue destroying APC in the duodenum is challenging due to the anatomy of the duodenal wall which is thin and therefore susceptible to thermal damage.

The application of low-thermal argonplasma in the GI tract could be just as useful as it was suggested for the treatment of neoplastic tissue in gynecology. Low-thermal APC using Erbe Standard 3.2 mm FiAPC probe and Precise mode was successfully applied for the remission of cervical intraepithelial neoplasia. The formation of reactive oxygen and nitric oxide species has been discussed as trigger for the effect on neoplasia tissue of low-thermal argonplasma.

Regarding current knowledge this is the first application of this APC modality in the GI tract.

Conditions

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Adenomatous Polyposis Coli Familial Adenomatous Polyposis Duodenal Adenoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

peri-ampullary FAP polyps of size smaller than 10 mm will be treated with low energy argonplasma coagulation
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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duodenal polyps <10 mm

low energy argonplasma coagulation

Group Type EXPERIMENTAL

low energy argonplasma coagulation

Intervention Type DEVICE

see above

Interventions

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low energy argonplasma coagulation

see above

Intervention Type DEVICE

Other Intervention Names

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cold APC

Eligibility Criteria

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Inclusion Criteria

* confirmed FAP disease
* duodenal polyposis with recommendation of a follow-up EGD in 12 months corresponding to stage III (7-8 points) according to Spigelman
* presence of duodenal polyps \< 10 mm
* written Informed Consent

Exclusion Criteria

* presence of lesions that are suspicious of the presence of high-grade dysplasia or carcinoma
* pregnancy or breastfeeding
* severe general illnesses (permanent ASA (American Society of Anesthesiologists) III and IV) who do not prognostically benefit from follow-up, life expectancy \< 1 year
* severe coagulopathy
* any visible state of duodenal surface that makes APC treatment impossible, e.g. inflammation, stricture, stenosis or scarring changes/scar areas
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universitätsklinikum Hamburg-Eppendorf

OTHER

Sponsor Role lead

Responsible Party

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Prof. Dr. Thomas Rösch

Prof. Dr. Thomas Roesch Medical Director, Interdisciplinary Endoscopy Department and Clinic University Hospital Hamburg-Eppendorf

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Thomas Rösch, Professor

Role: PRINCIPAL_INVESTIGATOR

Universitätskrankenhaus Hamburg-Eppendorf

Locations

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University Hospital Hamburg-Eppendorf

Hamburg, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Thomas Rösch, Professor

Role: CONTACT

+49407410 ext. 50098

Tania Ruppenthal

Role: CONTACT

+49407410 ext. 50089

Facility Contacts

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Thomas Rösch, Professor

Role: primary

+49407410 ext. 50098

Tania Ruppenthal

Role: backup

+49407410 ext. 50089

References

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Related Links

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http://www.leitlinienprogramm-onkologie.de/leitlinien/kolorektales-karzinom/

German oncological guidelines for colorectal cancer

Other Identifiers

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2023-101193-BO-ff

Identifier Type: -

Identifier Source: org_study_id

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