PERLA
Research type
Research Study
Full title
Prospective randomised comparison of en-bloc versus piecemeal resection of large rectal adenomas
IRAS ID
229105
Contact name
Pradeep Bhandari
Contact email
Sponsor organisation
Portsmouth Hospitals NHS Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
2 years, 2 months, 6 days
Research summary
Colonoscopy is currently the best procedure for recognising intestinal tumours and polyps as it allows lesions to be biopsied and removed. During a colonoscopy, polyps (also known as adenomas) are found in 20-30% of cases and can be resected as part of the same procedure. For larger polyps - 2 cm or more, a technique called piecemeal endoscopic mucosal resection (EMR) is carried out, where the polyp is removed in several pieces. This technique is limited as from a histological and oncological point of view it would be better to analyse a specimen that is removed in its entirety for an adequate assessment. In addition evidence suggests that recurrence rates of large adenomas can be reduced with an alternative method called endoscopic submucosal dissection (ESD), where an incision is made around the polyp prior to removal in one piece.
Evidence in comparing EMR and ESD is unclear with regard to efficacy, oncological resection, recurrence rate and perforation. To date there have been no randomised control trials of the two techniques. This study will be the first randomised study to compare both procedures. The results of this study will have an impact on the patient pathway.REC name
West Midlands - Solihull Research Ethics Committee
REC reference
19/WM/0163
Date of REC Opinion
31 May 2019
REC opinion
Further Information Favourable Opinion