Treatment strategy for recurrent or residual colorectal tumors after endoscopic resection

Sakamoto, Taku; Saito, Yutaka; Matsuda, Takahisa; Fukunaga, Shusei; Nakajima, Takeshi; Fujii, Takeshi

doi:10.1007/s00464-010-1169-9

Cited by 77 publications

(73 citation statements)

References 24 publications

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“…We previously reported that the recurrent or residual lesions did not show increased levels of histological atypia; they were mainly recognized as adenomas, even when the patients had been initially diagnosed with intramucosal carcinoma [11]. Thus, the efficacy of EPMR for certain types of lesions was confirmed.…”

Section: Introductionmentioning

confidence: 83%

Predictive factors of local recurrence after endoscopic piecemeal mucosal resection

et al. 2012

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Section: Introductionmentioning

confidence: 83%

Predictive factors of local recurrence after endoscopic piecemeal mucosal resection

et al. 2012

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“…Compared to the classical OTSC the clip used in the FTRD has additional lateral teeth in order to ensure a safe closure of the defect before resection. The FTRD cap is longer compared to the standard OTSC (23 mm vs 6 mm) and thus accommodates a tissue volume of approximately 3 cm 3 . This allows the capture of lesions of up to 30 mm in diameter.…”

Section: Description Of the Ftrd Devicementioning

confidence: 99%

Endoscopic full thickness resection (EFTR) of colorectal neoplasms with the Full Thickness Resection Device (FTRD): Clinical experience from two tertiary referral centers in Switzerland

Aepli

Criblez

Baumeler

et al. 2017

United European Gastroenterology Journal

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Background: Endoscopic full thickness resection (EFTR) by the Full Thickness Resection Device (FTRD) has recently been introduced as a method to allow resection of certain lesions such as adenomatous polyps that would not be resectable by standard polypectomy techniques. We report our clinical experience with FTRD procedures, assessing technical success, completeness of resection (R0 status), rate of histologically proven FTR and safety. Patients and methods:We conducted a retrospective analysis of 33 consecutive patients with colonic polyps treated with FTRD from May 2015 to November 2016. Results: Indications mainly were adenoma recurrence or residual adenoma with nonlifting sign after previous polypectomy. In the 31 cases amenable to EFTR, resection was en bloc and histologically complete (R0) in 87.9% (29/33) of patients. Histologically confirmed complete full thickness resection (FTR) was achieved in 80.6% (25/31). Three post-procedure bleedings and one perforation were seen. Conclusion: FTRD offers an additional endoscopic approach to treat nonlifting colorectal lesions. EFTR by FTRD appears to be feasible and efficacious in the resection of benign neoplasms of up to 30 mm in diameter and may be an alternative to surgery in selected patients. Given a significant rate of complications, safety is a concern and needs to be assessed in larger prospective studies.

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“…Although recurrent disease after endoscopic resection can be treated with ESD, equivalent long-term outcomes were seen in a retrospective study where further EMR was permitted [85].…”

Section: Emr Versus Esd: Complimentary Strategiesmentioning

confidence: 84%

Advanced endoscopic resection in the colon: recent innovations, current limitations and future directions

Tutticci

Bourke

2013

Expert Review of Gastroenterology & Hepatology

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The major health burden of colorectal cancer is reduced by colonoscopic polypectomy. The majority of polyps encountered are diminutive in size and easily removed; however, endoscopic removal of lesions >20 mm in size is also effective and safe. Techniques have progressed, advancing the boundaries of endoscopic therapy to include resection of circumferential lesions and selected submucosal invasive cancers. While there are cost and safety advantages over surgical management, specific limitations of endoscopic resection remain, chiefly bleeding, perforation and recurrence. Recent studies highlight the utility of risk stratification and demonstrate the effectiveness of endoscopic treatment of complications; however, strategies for prevention remain elusive. Prediction of submucosal invasive cancers through systematic assessment of lesion morphology and surface pattern is now established. Harnessing submucosal invasive cancer prediction and risk stratification allows a shift toward lesion-specific therapy, the next paradigm in the management of advanced colonic lesions.

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Treatment strategy for recurrent or residual colorectal tumors after endoscopic resection

Abstract: ESD is safe and effective for the treatment of recurrent or residual colorectal tumors. However, because of its technical difficulty, the en bloc resection rate is lower than that for the treatment of nonrecurrent lesions.

Cited by 77 publications

References 24 publications

Predictive factors of local recurrence after endoscopic piecemeal mucosal resection

Predictive factors of local recurrence after endoscopic piecemeal mucosal resection

Endoscopic full thickness resection (EFTR) of colorectal neoplasms with the Full Thickness Resection Device (FTRD): Clinical experience from two tertiary referral centers in Switzerland

Advanced endoscopic resection in the colon: recent innovations, current limitations and future directions

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