Endoscopic Full-Thickness Resection of Colorectal Lesions with the New FTRD System: Single-Center Experience

de-Ferro, Susana Mão; Castela, Joana; Pereira, Daniela Vinha; Chaves, Paula; Pereira, António Dias

doi:10.1159/000493808

Cited by 16 publications

(8 citation statements)

References 19 publications

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“…Procedure-related, mostly moderate complications were observed in 17.5% including 2 cases of acute gangrenous appendicitis requiring operation. Real-world data of eFTR performed by endoscopists in hospitals with a lower level of care and outside of published studies are rare [21][22][23][24][25][26][27][28][29]. In particular, it is not clear whether the positive results of the published studies obtained in referral centers can be transferred to the performance quality in other hospitals.…”

Section: Discussionmentioning

confidence: 99%

Technical success, resection status, and procedural complication rate of colonoscopic full-wall resection: a pooled analysis from 7 hospitals of different care levels

et al. 2020

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Introduction Endoscopic full-thickness resection (eFTR) using the full-thickness resection device (FTRD®) is a novel minimally invasive procedure that allows the resection of various lesions in the gastrointestinal tract including the colorectum. Real-world data outside of published studies are limited. The aim of this study was a detailed analysis of the outcomes of colonoscopic eFTR in different hospitals from different care levels in correlation with the number of endoscopists performing eFTR. Material and methods In this case series, the data of all patients who underwent eFTR between November 2014 and June 2019 (performed by a total of 22 endoscopists) in 7 hospitals were analyzed retrospectively regarding rates of technical success, R0 resection, and procedure-related complications. Results Colonoscopic eFTR was performed in 229 patients (64.6% men; average age 69.3 ± 10.3 years) mainly on the basis of the following indication: 69.9% difficult adenomas, 21.0% gastrointestinal adenocarcinomas, and 7.9% subepithelial tumors. The average size of the lesions was 16.3 mm. Technical success rate of eFTR was achieved in 83.8% (binominal confidence interval 78.4-88.4%). Overall, histologically complete resection (R0) was achieved in 77.2% (CI 69.8-83.6%) while histologically proven full-wall excidate was confirmed in 90.0% (CI 85.1-93.7%). Of the resectates obtained (n = 210), 190 were resected en bloc (90.5%). We did not observe a clear improvement of technical success and R0 resection rate over and Other Interventional Techniques Parts of the data have already been presented as a lecture at the annual meetings of the DGVS 2018 and 2019 and published as an abstract (I Krutzenbichler, M Fuchs, B Lewerenz, T Leimbach, A Nehrlich, W Schepp, F Gundling. Application of endoscopic full-wall resection using the "full-thickness resection device" (FTRD®) regarding technical success rate and procedural complications-a single-center study,

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Section: Discussionmentioning

confidence: 99%

Technical success, resection status, and procedural complication rate of colonoscopic full-wall resection: a pooled analysis from 7 hospitals of different care levels

et al. 2020

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“…Main characteristics of the included studies are provided in ▶ Table 1 [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Overall, 15 (83.3 %) studies were performed in Europe, two (11.1 %) being from the United States and one (5.5 %) from China.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Endoscopic full-thickness resection using a clip non-exposed method for gastrointestinal tract lesions: a meta-analysis

et al. 2020

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Background and study aims Endoscopic full-thickness resection (EFTR) allows for treatment of epithelial and sub-epithelial lesions (SELs) unsuitable to conventional resection techniques. This meta-analysis aimed to assess the efficacy and safety of clip-assisted method for non-exposed EFTR using FTRD or over-the-scope clip of gastrointestinal tumors. Methods A comprehensive literature search was performed. The primary outcome of interest was the rate of histologic complete resection (R0). Secondary outcomes of interest were the rate of enbloc resection, FTR, adverse events, and post-EFTR surgery. Random-effects model was used to calculate pooled estimates and generate forest plots. Results Eighteen studies with 730 patients and 733 lesions were included in the analyses. Indications for EFTR were difficult/residual colorectal adenoma, adenoma at a diverticulum or appendiceal orifice and early cancer (n = 634), colorectal SELs (n = 42), and upper gastrointestinal lesions (n = 51), other colonic lesions (n = 6). Median size of lesions was 13.5 mm. There were 22 failed EFTR attempts. Pooled overall R0 resection rate was 82 % (95 % CI: 75, 89). The pooled overall FTR rate was 83 % (95 % CI: 77, 89). The pooled overall enbloc resection rate was 95 (95 % CI: 92, 96). The pooled estimates for perforation and bleeding were < 0.1 % and 2 %, respectively. Following EFTR, a total of 110 patients underwent surgery for any reason [pooled rate 7 % (95 % 2, 14). The pooled rates for post-EFTR surgery due to invasive cancer, for non-curative endoscopic resection and for adverse events were 4 %, < 0.1 % and < 0.1 %, respectively. No mortality related to EFTR was noted. Conclusions EFTR appears to be safe and effective for gastrointestinal lesions that are not amenable to conventional endoscopic resection. This technique should be considered as an alternative to surgery in selected cases.

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“…However, polyps arising within or near colonic diverticula pose an increased challenge to the gastroenterologist because of the increased risk of perforation. To minimize this risk, new techniques such as endoscopic full-thickness resection have been developed, which allows for complete resection of the lesion 3 ; nevertheless, despite its increased availability, it still requires additional training and poses additional costs.…”

Section: Case Discussionmentioning

confidence: 99%

Band ligation-assisted endoscopic mucosal resection of an intradiverticular polyp

2021

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Endoscopic Full-Thickness Resection of Colorectal Lesions with the New FTRD System: Single-Center Experience

Cited by 16 publications

References 19 publications

Technical success, resection status, and procedural complication rate of colonoscopic full-wall resection: a pooled analysis from 7 hospitals of different care levels

Technical success, resection status, and procedural complication rate of colonoscopic full-wall resection: a pooled analysis from 7 hospitals of different care levels

Endoscopic full-thickness resection using a clip non-exposed method for gastrointestinal tract lesions: a meta-analysis

Band ligation-assisted endoscopic mucosal resection of an intradiverticular polyp

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