Impact of Hybrid-ESD+ and LiftUp® on the en Bloc/R0 Rate in Colorectal Adenomas Between 2 and 3 cm (HADRIAN)

  • End date
    Oct 23, 2024
  • participants needed
  • sponsor
    Wuerzburg University Hospital
Updated on 7 October 2022


This study examines whether the use of Hybrid-ESD+ with LiftUp (Injection solution) results in a higher en bloc and/or R0 rate for non pedunculated colorectal adenomas between 2 and 3 cm than described in the literature for conventional EMR.


There are several options for endoscopic polypectomy of polyps between 2-3 cm, all of which have their advantages and disadvantages and none of which has yet become the established standard procedure.

Conventional EMR has the disadvantage of more frequent residuals and/or recurrences due to lack of en bloc resection, while ESD has the disadvantage of being more complex and complications more likely.

A possible alternative is the use of hybrid ESD+ with LiftUp subcutaneous injection. The method with the LiftUp gel forming a stable gel cushion under the lesion, in combination with the circular circumcision of the mucosa at this site and the AWC for the current loop and the grasper, could achieve a better en bloc resection rate with a low complication rate than other procedures mentioned above.

The higher effectiveness in terms of recurrences and complications could subsequently result in a reduction of endoscopic or surgical re-interventions.

In this study, non-pedunculated colorectal polyps between 2 and 3cm in size are resected using ESD+ method and lift up as an injection solution.

Methodological and clinical parameters are recorded. After 4 weeks, the patients are contacted by telephone to record possible late effects.

If an endoscopic control is performed after 6 months (according to the guideline or according to the investigator), the findings are also recorded.

Condition Colorectal Adenoma
Treatment Hybrid ESD+
Clinical Study IdentifierNCT05517369
SponsorWuerzburg University Hospital
Last Modified on7 October 2022


Yes No Not Sure

Inclusion Criteria

Non-pedunculated lesion in the colorectum (epithelial lesion, 2-3 cm)
Ablation medically indicated and possible (coagulation, etc. - as determined by the center)

Exclusion Criteria

Age < 18 years
Pedunculated lesion (Paris0-Ip)
Size of the lesion <2cm or >3cm
Pregnant and breastfeeding women
Patient not capable of informed consent / consent not possible
Bioptic evidence of a carcinoma / high probability of the presence of a carcinoma
Non-lifting sign / known recurrence after previous therapy
Impassable stenosis in the colon / rectum
Patients with compelling need for therapeutic anticoagulation or dual antiplatelet therapy that cannot be discontinued for resection
As per contraindications from the AWC & LiftUp Instructions for Use
The AWC is not to be used if flexible-endoscopic procedures are contraindicated
The LiftUp gel should not be used when flexible endoscopic procedures are contraindicated, especially in combination with submucosal endoscopic resection (EMR) or endoscopic submucosal dissection (ESD) injectables
LiftUp gel should not be used in patients with known sensitivity to any of the ingredients
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