Endoscopic full-thickness resection (EFTR) in the lower gastrointestinal tract

Albrecht, Heinz; Raithel, Martin; Braun, Alexander; Nägel, Andreas; Stegmaier, A.; Utpatel, Kirsten; Schäfer, Claus

doi:10.1007/s10151-019-02043-5

Cited by 34 publications

(49 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Endoscopic full-thickness resection (EFTR) is a newer technique wherein an over-the-scope clip is deployed over an adequately grasped/suctioned lesion (typically through a transparent cap), and the lesion is subsequently removed with a snare [34][35][36][37][38][39]. The technical success of EFTR for benign, recurrent adenomas with non-lifting sign, advanced histopathological findings, or submucosal involvement approached 75 % to 100 % and histologically complete resection (R0) rates of 80 % to 93 % has led to curative resection of advanced benign and malignant lesions, obviating the need for surgery, particularly for lesions limited to the superficial submucosa without evidence of lymphovascular invasion or poor grade of differentiation [35][36][37][38][39]. Applied to previously manipulated lesions, R0 resection rates approach 89 % [35][36][37][38][39].…”

Section: Locationmentioning

confidence: 99%

“…The technical success of EFTR for benign, recurrent adenomas with non-lifting sign, advanced histopathological findings, or submucosal involvement approached 75 % to 100 % and histologically complete resection (R0) rates of 80 % to 93 % has led to curative resection of advanced benign and malignant lesions, obviating the need for surgery, particularly for lesions limited to the superficial submucosa without evidence of lymphovascular invasion or poor grade of differentiation [35][36][37][38][39]. Applied to previously manipulated lesions, R0 resection rates approach 89 % [35][36][37][38][39]. However, while surgery can be avoided in many cases in which EFTR is used, R0 resection rates are lower for lesions greater than 2 cm in size (33 %-87 %) and those that contain adenocarcinoma (67 %), and a total complication rate of 5 %-15 % was observed in studies published to date [34][35][36][37][38][39].…”

Section: Locationmentioning

confidence: 99%

“…Applied to previously manipulated lesions, R0 resection rates approach 89 % [35][36][37][38][39]. However, while surgery can be avoided in many cases in which EFTR is used, R0 resection rates are lower for lesions greater than 2 cm in size (33 %-87 %) and those that contain adenocarcinoma (67 %), and a total complication rate of 5 %-15 % was observed in studies published to date [34][35][36][37][38][39]. A hybrid EMR-EFTR techniquewherein the lifting portions of the lesion are removed by EMR and the nonlifting portions removed by EFTRwas developed to address the size limitation of EFTR and was applied to colonic lesions with a median size of 35.5 mm with 100 % R0 resection rate, no residual or recurrent adenoma at 3-month follow up, and no reported complications [40].…”

Section: Locationmentioning

confidence: 99%

See 2 more Smart Citations

Dissection-enabled scaffold-assisted resection (DeSCAR): a novel technique for resection of residual or non-lifting gastrointestinal neoplasia of the colon, expanded experience and follow-up

et al. 2020

View full text Add to dashboard Cite

Background and study aims Colonic lesions may not be amenable to conventional endoscopic mucosal resection (EMR) due to previous manipulation, submucosal invasion, or lesion flatness. In 2018, we described Dissection-enabled Scaffold Assisted Resection (DeSCAR) to be safe for the endoscopic resection of non-lifting or residual colonic lesions 1 In this study, we expand our original cohort to describe our expanded experience with patients undergoing DeSCAR and assess the efficacy, safety, and feasibility of DeSCAR for endoscopic resection of non-lifting or residual colonic lesions. Patients and methods We retrospectively reviewed 57 patients from 2015–2019 who underwent DeSCAR for colonic lesions with incomplete lifting and/or previous manipulation. Cases were reviewed for location, prior manipulation, rates of successful resection, adverse events, and endoscopic follow up to assess for residual lesions. Results Fifty-seven lesions underwent DeSCAR. Of the patients, 51 % were female, and average patient age was 69 years. Lesions were located in the cecum (n = 16), right colon (n = 27), left colon (n = 10), and rectum (n = 4). Average lesion size was 27.7 mm. Previous manipulation occurred in 54 cases (72 % biopsy, 44 % resection attempt, 18 % intralesional tattoo). The technical success rate for resection of non-lifting lesions was 98 %. There were two delayed bleeding episodes (one required endoscopic intervention) and one small perforation (managed by endoscopic hemoclip closure). Endoscopic follow up was available in 31 patients (54 %) with no residual adenoma in 28 patients (90 % of those surveilled). Conclusions Our expanded experience with DeSCAR demonstrates high safety, feasibility, and effectiveness for the endoscopic management of non-lifting or residual colonic lesions.

show abstract

Section: Locationmentioning

confidence: 99%

Section: Locationmentioning

confidence: 99%

Section: Locationmentioning

confidence: 99%

See 1 more Smart Citation

Dissection-enabled scaffold-assisted resection (DeSCAR): a novel technique for resection of residual or non-lifting gastrointestinal neoplasia of the colon, expanded experience and follow-up

et al. 2020

View full text Add to dashboard Cite

show abstract

“…

Ressecção endoscópica de tumor neuroendócrino duodenal com um novo dispositivo de ressecção transmural

Palavras ChaveEndoscopia · Duodeno · Tumor neuroendócrino · Ressecção transmural Most well-differentiated, non-functional duodenal neuroendocrine tumours (NETs) limited to the mucosa/ submucosa can be treated effectively with endoscopic resection [1]. A full-thickness resection device (FTRD; Ovesco Endoscopy ® ) enables endoscopic transmural resection of suitable lesions with a fast minimally invasive technique [2]. A colonic FTRD was used for duodenal lesions as an "off-label" indication with good clinical outcomes and a complication rate comparable to duodenal endoscopic mucosal resection [3].

…”

mentioning

confidence: 99%

Duodenal Neuroendocrine Tumour Resection with a New Duodenal Full-Thickness Resection Device

Cortez-Pinto

Ferro

Castela

et al. 2020

GE Port J Gastroenterol

View full text Add to dashboard Cite

Ressecção endoscópica de tumor neuroendócrino duodenal com um novo dispositivo de ressecção transmural Palavras ChaveEndoscopia · Duodeno · Tumor neuroendócrino · Ressecção transmural Most well-differentiated, non-functional duodenal neuroendocrine tumours (NETs) limited to the mucosa/ submucosa can be treated effectively with endoscopic resection [1]. A full-thickness resection device (FTRD; Ovesco Endoscopy ® ) enables endoscopic transmural resection of suitable lesions with a fast minimally invasive technique [2]. A colonic FTRD was used for duodenal lesions as an "off-label" indication with good clinical outcomes and a complication rate comparable to duodenal endoscopic mucosal resection [3]. A duodenal FTRD (d-FTRD) with smaller diameter (19.5 vs. 21 mm), balloonassisted insertion and less clip interdental space was developed allowing easier upper oesophageal sphincter passage and minimising bleeding risk.We describe a 74-year-old male with a 10-mm postpyloric bulbar submucosal lesion (Fig. 1, 2) with biopsies showing a well-differentiated NET. Endoscopic ultrasonography showed a submucosal lesion. Endoscopic ultrasonography and 68-Ga DOTA-NOC PET/CT displayed no lymph node involvement or distant metastases. An attempt to resect with band ligation endoscopic mucosal resection failed because of an absence of aspiration into the cap. Transmural resection with the d-FTRD was scheduled in the operating room under general anaesthesia. Lesion borders were marked with argon plasma coagulation. Upper oesophageal sphincter dilation was performed with Savary-Gilliard bougie dilator (15-18 mm) allowing d-FTRD insertion. A paediatric colonoscope (outer diameter: 11.8 mm; working channel calibre: 3.2 mm) was then advanced to the duodenum with the d-FTRD attached. Traction of the lesion to the cap with the grasper and slight aspiration were done, followed by overthe-scope clip release (d-FTRD clip). Aspiration was nec-This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission.

show abstract

“…This technique is a new tool in the endoscopist's armamentarium, and the evidence of its feasibility is accumulating. In the recent paper by Albrecht et al, a case series about the FTRD system showed good results in resecting non-lifting lesions of the colon with a high rate of R0 resection, nearly 90% [5]. One's first impression is that resecting the full wall could increase oncological radicality: is it true?…”

mentioning

confidence: 99%

Resection of colonic lesions: full thickness, full monty?

Pagano

2019

Tech Coloproctol

View full text Add to dashboard Cite

Endoscopic full-thickness resection (EFTR) in the lower gastrointestinal tract

Cited by 34 publications

References 19 publications

Dissection-enabled scaffold-assisted resection (DeSCAR): a novel technique for resection of residual or non-lifting gastrointestinal neoplasia of the colon, expanded experience and follow-up

Dissection-enabled scaffold-assisted resection (DeSCAR): a novel technique for resection of residual or non-lifting gastrointestinal neoplasia of the colon, expanded experience and follow-up

Duodenal Neuroendocrine Tumour Resection with a New Duodenal Full-Thickness Resection Device

Resection of colonic lesions: full thickness, full monty?

Contact Info

Product

Resources

About