Thomas Rösch, Prof. Dr. Principal Investigator Ph D, Director, Head of department
Kontakt
Thomas Rösch, Prof. Dr. Kontakt: Phone: + 49 40 7410 Phone (ext.): 50098 E-Mail: t.roesch@uke.de» Kontaktdaten anzeigen Hanno Ehlken, Dr. Kontakt: Phone: + 49 40 7410 Phone (ext.): 18232 E-Mail: h.ehlken@uke.de» Kontaktdaten anzeigen
Studienlocations (2 von 2)
University Medical Center Hamburg-Eppendorf 20246 Hamburg (Hamburg) GermanyRekrutierend» Google-Maps Ansprechpartner: Thomas Rösch, Prof. Dr. Phone: + 49 40 7410 Phone (ext.): 50098 E-Mail: t.roesch@uke.de
1. Eradication rate of neoplastic Barrett's Esophagus, initial therapy success (Time Frame - 3 months after end of therapy (resection and ablation)): Rate of complete and curative eradication, free of recurrence of neoplastic Barrett's Esophagus. Endoscopical diagnostic and negative histologies for any kind of neoplasia, measured in follow up control EGD 3 months after end of treatment
2. Eradication rate of neoplastic Barrett's Esophagus, initial therapy success (Time Frame - 9 months after end of therapy (resection and ablation)): Rate of complete and curative eradication, free of recurrence of neoplastic Barrett's Esophagus. Endoscopical diagnostic and negative histologies for any kind of neoplasia, measured in follow up control EGD 9 months after end of treatment
3. Eradication rate of neoplastic Barrett's Esophagus (Time Frame - 24 months after end of therapy (resection and ablation)): Rate of complete and curative eradication, free of recurrence of neoplastic Barrett's Esophagus. Endoscopical diagnostic and negative histologies for any kind of neoplasia, measured in follow up control 24 months after end of treatment
4. Eradication rate of neoplastic Barrett's Esophagus (Time Frame - 33 months after end of therapy (resection and ablation)): Rate of complete and curative eradication, free of recurrence of neoplastic Barrett's Esophagus. Endoscopical diagnostic and negative histologies for any kind of neoplasia, measured in follow up control EGD 33 months after end of treatment
Secondary outcome:
1. Eradication rate of complete Barrett's Esophagus, initial therapy success (Time Frame - 3 months after end of treatment (resection and ablation)): Rate of complete and curative eradication, free of recurrence of neoplastic and non-neoplastic Barrett's Esophagus. Endoscopical diagnostics and negative histologies for any kind of neoplasia and Barrett's metaplasia measured in follow up control EGD 3 months after end of treatment
2. Eradication rate of complete Barrett's Esophagus, initial therapy success (Time Frame - 9 months after end of treatment (resection and ablation)): Rate of complete and curative eradication, free of recurrence of neoplastic and non-neoplastic Barrett's Esophagus. Endoscopical diagnostics and negative histologies for any kind of neoplasia and Barrett's metaplasia measured in follow up control EGD 9 months after end of treatment
3. Eradication rate of complete Barrett's Esophagus, freedom of recurrence (Time Frame - 24 months after end of treatment (resection and ablation)): Rate of complete and curative eradication, free of recurrence of neoplastic and non-neoplastic Barrett's Esophagus. Endoscopical diagnostics and negative histologies for any kind of neoplasia and Barrett's metaplasia measured in follow up control EGD 24 months after end of treatment
4. Eradication rate of complete Barrett's Esophagus, freedom of recurrence (Time Frame - 33 months after end of treatment (resection and ablation)): Rate of complete and curative eradication, free of recurrence of neoplastic and non-neoplastic Barrett's Esophagus. Endoscopical diagnostics and negative histologies for any kind of neoplasia and Barrett's metaplasia measured in follow up control EGD 33 months after end of treatment
5. Recurrence rate of neoplastic Barrett's Esophagus, initial therapy success (Time Frame - 3 months after end of therapy (resection and ablation)): rate of complete and curative eradication of neoplastic Barrett's Esophagus measured in follow up control EGD 3 months, Endoscopical diagnostic and negative histologies for any kind of neoplasia.
6. Recurrence rate of neoplastic Barrett's Esophagus, initial therapy success (Time Frame - 9 months after end of therapy (resection and ablation)): rate of complete and curative eradication of neoplastic Barrett's Esophagus measured in follow up control EGD 9 months , Endoscopical diagnostic and negative histologies for any kind of neoplasia.
7. freedom of recurrence rate of complete Barrett's Esophagus, initial therapy success (Time Frame - 9 months after end of treatment (resection and ablation)): Freedom of recurrence rate of neoplastic and non-neoplastic Barrett's Esophagus. Endoscopical diagnostics and negative histologies for any kind of neoplasia and Barrett's metaplasia measured in follow up control EGD 9 months (initial therapy success) after end of treatment
8. ESD success of resection (Time Frame - 2 days): rate of en bloc and R0 resections among the initially by ESD resected tissues
9. EMR success of resection (Time Frame - 9 months after end of treatment (resection and ablation)): Since with EMR resection success can only be measured for the depth of base initially, the second control EGD with negative histology has been chosen for Gold standard indication for resection success. After 2 negative bioptic controls a piecemeal resection of early carcinoma is classified as complete.
10. Surveillance of Barrett's mucosa after incomplete resections and recurrences (Time Frame - 51 months): follow up of all cases with initially incomplete EMR or ESD resections as well as recurrences after resection and ablation
11. conclusions of Tumor Board in case of re resection and outcome if postitive cancer histology (Time Frame - 51 months): any Treatment and follow up in case of positive cancer histology
12. Determination of differences in Barrett's esophagus subtypes: size (Time Frame - 3 months): size of Barrett's mucosa, e.g. Prague Classification
13. Determination of differences in Barrett's esophagus subtypes: form (Time Frame - 3 months): form of Barrett's mucosa
14. Determination of differences in Barrett's esophagus subtypes: patterns (Time Frame - 3 months): patterns of Barrett's mucosa, e,g, Kudo Classification
15. Determination of differences in Barrett's esophagus subtypes: histologies (Time Frame - 3 months): histological assessment of Barrett's mucosa
16. Intervention time (Time Frame - 18 months): time requested for each resection and ablative sessions
Endoscopic mucosal resection (EMR / Piecemeal EMR / ): Endoscopic resection is carried out using a double-channel scope. The lesion borders are marked with a coagulator. Saline liquid and sometimes epinephrine are injected into the submucosal layer to swell the area containing the lesion and elucidate the markings. The resected mucosa is lifted, then trapped and strangulated with a snare, and subsequently resected by electrocautery. Another method of EMR employs the use of a clear cap and prelooped snare inside the cap. After insertion, the cap is placed on the lesion and the mucosa containing the lesion is drawn up inside the cap by aspiration. The mucosa is caught by the snare and strangulated, and finally resected by electrocautery.
Endoscopic submucosal dissection (ESD): After circumferential cutting of the surrounding mucosa of the lesion, fluid is injected into the submucosa to elevate the lesion from the muscle layer, and the connective tissue of the submucosa beneath the lesion is dissected subsequently.
Quelle: ClinicalTrials.gov
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"Neoplastic Barrett Esophagus: Endoscopic Piecemeal vs. En Bloc Resection"
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