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DC Field | Value | Language |
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dc.contributor.author | Meulen, L. W. T. | - |
dc.contributor.author | Bogie, R. M. M. | - |
dc.contributor.author | Siersema, P. D. | - |
dc.contributor.author | Winkens, B. | - |
dc.contributor.author | Vlug, M. S. | - |
dc.contributor.author | Wolfhagen, F. H. J. | - |
dc.contributor.author | Baven-Pronk, M. | - |
dc.contributor.author | van der Voorn, M. | - |
dc.contributor.author | Schwartz, M. P. | - |
dc.contributor.author | Vogelaar, L. | - |
dc.contributor.author | de Vos Tot Nederveen Cappel, W. H. | - |
dc.contributor.author | Seerden, T. C. J. | - |
dc.contributor.author | Hazen, W. L. | - |
dc.contributor.author | Schrauwen, R. W. M. | - |
dc.contributor.author | Alvarez Herrero, L. | - |
dc.contributor.author | Schreuder, R. M. | - |
dc.contributor.author | van Nunen, A. B. | - |
dc.contributor.author | Stoop, E. | - |
dc.contributor.author | de Bruin, G. J. | - |
dc.contributor.author | Bos, P. | - |
dc.contributor.author | Marsman, W. A. | - |
dc.contributor.author | Kuiper, E. | - |
dc.contributor.author | de Bievre, M. | - |
dc.contributor.author | Alderlieste, Y. A. | - |
dc.contributor.author | Roomer, R. | - |
dc.contributor.author | Groen, J. | - |
dc.contributor.author | Bargeman, M. | - |
dc.contributor.author | van Leerdam, M. E. | - |
dc.contributor.author | Roberts-Bos, L. | - |
dc.contributor.author | Boersma, F. | - |
dc.contributor.author | Thurnau, K. | - |
dc.contributor.author | de Vries, R. S. | - |
dc.contributor.author | Ramaker, J. M. | - |
dc.contributor.author | Vleggaar, F. P. | - |
dc.contributor.author | de Ridder, R. J. | - |
dc.contributor.author | Pellise, M. | - |
dc.contributor.author | Bourke, M. J. | - |
dc.contributor.author | Masclee, A. A. M. | - |
dc.contributor.author | Moons, L. M. G. | - |
dc.date.accessioned | 2024-05-16T03:11:21Z | - |
dc.date.available | 2024-05-16T03:11:21Z | - |
dc.date.issued | 2024 | - |
dc.identifier.uri | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/9613 | - |
dc.description.abstract | OBJECTIVE: Endoscopic mucosal resection (EMR) is the preferred treatment for non-invasive large (>=20 mm) non-pedunculated colorectal polyps (LNPCPs) but is associated with an early recurrence rate of up to 30%. We evaluated whether standardised EMR training could reduce recurrence rates in Dutch community hospitals. DESIGN: In this multicentre cluster randomised trial, 59 endoscopists from 30 hospitals were randomly assigned to the intervention group (e-learning and 2-day training including hands-on session) or control group. From April 2019 to August 2021, all consecutive EMR-treated LNPCPs were included. Primary endpoint was recurrence rate after 6 months. RESULTS: A total of 1412 LNPCPs were included; 699 in the intervention group and 713 in the control group (median size 30 mm vs 30 mm, 45% vs 52% size, morphology, site and access (SMSA) score IV, 64% vs 64% proximal location). Recurrence rates were lower in the intervention group compared with controls (13% vs 25%, OR 0.43; 95% CI 0.23 to 0.78; p=0.005) with similar complication rates (8% vs 9%, OR 0.93; 95% CI 0.64 to 1.36; p=0.720). Recurrences were more often unifocal in the intervention group (92% vs 76%; p=0.006). In sensitivity analysis, the benefit of the intervention on recurrence rate was only observed in the 20-40 mm LNPCPs (5% vs 20% in 20-29 mm, p=0.001; 10% vs 21% in 30-39 mm, p=0.013) but less evident in >=40 mm LNPCPs (24% vs 31%; p=0.151). In a post hoc analysis, the training effect was maintained in the study group, while in the control group the recurrence rate remained high. CONCLUSION: A compact standardised EMR training for LNPCPs significantly reduced recurrences in community hospitals. This strongly argues for a national dedicated training programme for endoscopists performing EMR of >=20 mm LNPCPs. Interestingly, in sensitivity analysis, this benefit was limited for LNPCPs >=40 mm. | - |
dc.subject | Colonic Polyps | - |
dc.subject | Colonoscopy | - |
dc.subject | Colorectal Neoplasms | - |
dc.subject | Endoscopic Mucosal Resection | - |
dc.title | Standardised training for endoscopic mucosal resection of large non-pedunculated colorectal polyps to reduce recurrence ( STAR-LNPCP study): a multicentre cluster randomised trial | - |
dc.type | Journal Article | - |
dc.identifier.doi | https://dx.doi.org/10.1136/gutjnl-2023-330020 | - |
dc.identifier.journaltitle | Gut | - |
dc.identifier.department | Gut 73(5):741-750, 2024 | - |
dc.contributor.wslhd | Bourke, Michael J. | - |
dc.type.studyortrial | Randomized Controlled Trial | - |
dc.type.studyortrial | Multicenter Study | - |
dc.identifier.pmid | 38216328 | - |
dc.identifier.facility | Westmead | - |
Appears in Collections: | Westmead Hospital 2019 - 2024 |
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