Endoscopic full-thickness resection with the full-thickness resection device (FTRD) for “difficult to resect” colonic lesions. A single-center experience

Damiano Bisogni, Luca Talamucci, Michele Rossi, Fabio Cianchi, Fabio Staderini, Luca Boni, Enrico Baria, Laura Fortuna, Roberto Manetti

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: Aim of our observational and retrospective study is to compare efficacy and indications of endoscopic full-thickness resection device (FTRD) with the over-the-scope (OVESCO) clip closure for en bloc resection of colorectal lesions (including adenomas, early carcinomas, inflammatory polyps and neuroendocrine tumors). MATERIAL AND METHODS: This article collected 36 cases of colorectal neoplasms from a single Italian referral center per colorectal disease treatment. Primary endpoints included en bloc resection, R0 resection and an early discharge of the patient. Secondary endpoints included procedure-related adverse events. Results: Mean procedure time± standard devia-tion (SD) was 19.6±22.1 minutes and mean hospital stay (± SD) was 2.2±1.1 days. Overall, an en bloc resection was achieved in 34 cases (94.4%), with an R0 resection rate of 91.6%. Among the three not R0 patients, further addi-tional treatments were needed. Discussion: Along the same line of other already published articles, the main current indications of EFTR by FTRD-OVESCO are limited to superficial or low-risk malignancy lesions (eg, adenomas, early can-cers or subepithelial tumors), not suitable to conventional endoscopic resection or in patients with a severe surgical risk. Both en bloc resection rate and complication rate are aligned with other authors’ data. CONCLUSIONS: EFTR by FTRD system represents an effective and safe options whenever a recurrent lesion in a chal-lenging environment occurres (eg, recent scar, low rectum or beyond a large colonic bend). Procedure-related adverse events are potentially severe, so that this novel technique should be performed by “expert hands”.

Original languageEnglish
Pages (from-to)486-493
Number of pages8
JournalAnnali Italiani di Chirurgia
Volume91
Issue number5
Publication statusPublished - Oct 2020

Keywords

  • Difficult polypectomies
  • Early carcinomas
  • Endoscopic Full-Thickness Resection (EFTR)
  • Full-Thickness Resection Device (FTRD) by Over-The-Scope (OVESCO) clip closure
  • Literature overview
  • Single center experience

ASJC Scopus subject areas

  • Surgery

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