NCT06937671

Brief Summary

The goal of this randomized clinical trial is to learn if a combination of hot and cold EMR technique is associated with a lower risk of polyp recurrence without increasing the risk of complication when removing large polyps. Participants will undergo EMR and return for a follow-up endoscopy in 3-6 months to check for polyp recurrence.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
194

participants targeted

Target at P75+ for not_applicable

Timeline
7mo left

Started May 2025

Geographic Reach
1 country

2 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress64%
May 2025Dec 2026

First Submitted

Initial submission to the registry

April 11, 2025

Completed
11 days until next milestone

First Posted

Study publicly available on registry

April 22, 2025

Completed
9 days until next milestone

Study Start

First participant enrolled

May 1, 2025

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2026

Last Updated

November 20, 2025

Status Verified

April 1, 2025

Enrollment Period

1.6 years

First QC Date

April 11, 2025

Last Update Submit

November 17, 2025

Conditions

Keywords

EMRCold EMRHybrid EMREndoscopic mucosal resection

Outcome Measures

Primary Outcomes (1)

  • Recurrence of polyps

    Recurrence of polyps confirmed by biopsy at the site of EMR on follow-up colonoscopy

    3-6 months after the procedure

Secondary Outcomes (4)

  • Adverse events

    3-6 months after the procedure

  • Polyp recurrence rates

    3-6 months after EMR procedure

  • Cost benefit analysis

    3-6 months after the procedure

  • Subgroup polyp recurrence rate

    3-6 months after the procedure

Study Arms (2)

Cold EMR

ACTIVE COMPARATOR

Control group patients that receive standard cold EMR treatment.

Procedure: Cold EMR

Hybrid cold EMR

EXPERIMENTAL

Intervention group patients. Patients will receive hybrid EMR treatment.

Procedure: Hybrid EMR

Interventions

Cold EMRPROCEDURE

Cold EMR with cold forceps (regular or jumbo forceps) removal of any visible neoplasia that cannot be ensnared.

Cold EMR
Hybrid EMRPROCEDURE

Cold EMR with hot avulsion of any visible residual neoplasia within the resection bed, in addition to precise APC of the fibrotic bands that may harbor invisible neoplasia within the resection bed.

Hybrid cold EMR

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult patient (age 18 years or older)
  • Polyp size of at least 20 mm
  • \- Morphology: Flat or superficially raised polyp morphology (i.e., Paris classification 1s, 0-IIa or 0-IIb, or a combination of the above)

You may not qualify if:

  • Polyps with previous failed resection attempts or polyp recurrence
  • Suspected deep submucosal invasion on endoscopic assessment of surface mucosal pit pattern (Kudo V or NICE 3 pattern) or histologically confirmed malignancy (invasive adenocarcinoma)
  • Polyps with nodules too large (\>1-1.5cm) for the use of a cold snare
  • Inflammatory bowel disease

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Cleveland Clinic Weston

Weston, Florida, 33331, United States

RECRUITING

Cleveland Clinic

Cleveland, Ohio, 44195, United States

RECRUITING

MeSH Terms

Conditions

Colonic Polyps

Condition Hierarchy (Ancestors)

Intestinal PolypsPolypsPathological Conditions, AnatomicalPathological Conditions, Signs and Symptoms

Study Officials

  • Tilak Shah, M.D.

    Cleveland Clinic Florida (Weston Hospital)

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Akram Ahmad, M.D.

CONTACT

Michael Nicolas, B.S.

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Medical Doctor

Study Record Dates

First Submitted

April 11, 2025

First Posted

April 22, 2025

Study Start

May 1, 2025

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2026

Last Updated

November 20, 2025

Record last verified: 2025-04

Locations