TY - JOUR
T1 - Endoscopic full-thickness resection (eFTR) of colorectal lesions
T2 - results from the Dutch colorectal eFTR registry
AU - Zwager, Liselotte W.
AU - Bastiaansen, Barbara A. J.
AU - Bronzwaer, Maxime E. S.
AU - van der Spek, Bas W.
AU - Heine, G. Dimitri N.
AU - Haasnoot, Krijn J. C.
AU - van der Sluis, Hedwig
AU - Perk, Lars E.
AU - Boonstra, Jurjen J.
AU - Rietdijk, Svend T.
AU - Wolters, Hugo J.
AU - Weusten, Bas L. A. M.
AU - Gilissen, Lennard P. L.
AU - Ten Hove, W. Rogier
AU - Nagengast, Wouter B.
AU - Bekkering, Frank C.
AU - Schwartz, M. P.
AU - Droste, Jochim S. Terhaar Sive
AU - Vlug, Marije S.
AU - Houben, Martin H. M. G.
AU - Munoz, Francisco J. Rando
AU - Seerden, Tom C. J.
AU - Beaumont, Hanneke
AU - de Ridder, Rogier
AU - Dekker, Evelien
AU - Fockens, Paul
AU - Dutch eFTR Group
N1 - Funding Information:
P. Fockens receives personal fees from Cook, Ethicon, and Olympus, and research support from Boston Scientific outside the submitted work. E. Dekker has endoscopic equipment on loan from FujiFilm, and has received a research grant from FujiFilm, consultancy fees from FujiFilm, Olympus, Tillotts, GI Supply, and CPP-FAP, and speaker’s fees from Olympus, Roche, and GI Supply. B. Bastiaansen has received speaker’s fees from Olympus, Tillotts Pharma AG, and Ovesco Endoscopy AG. The remaining authors declare that they have no conflict of interest.
Publisher Copyright:
© 2020 Georg Thieme Verlag. All rights reserved.
PY - 2020/11
Y1 - 2020/11
N2 - Background Endoscopic full-thickness resection (eFTR) is a minimally invasive resection technique that allows definite diagnosis and treatment for complex colorectal lesionsMethods Consecutive patients undergoing eFTR in 20 hospitals were prospectively included. The primary outcome was technical success, defined as macroscopic complete en bloc resection. Secondary outcomes were: clinical success, defined as tumor-free resection margins (R0 resection); full-thickness resection rate; and adverse events.Results Between July 2015 and October 2018, 367 procedures were included. Indications were difficult polyps (non-lifting sign and/or difficult location; n = 133), primary resection of suspected T1 colorectal cancer (CRC; n = 71), reresection after incomplete resection of T1 CRC (n = 150), and subepithelial tumors (n = 13). Technical success was achieved in 308 procedures (83.9%). In 21 procedures (5.7 %), eFTR was not performed because the lesion could not be reached or retracted into the cap. In the remaining 346 procedures, R0 resection was achieved in 285 (82.4%) and full-thickness resection in 288 (83.2%). The median diameter of resected specimens was 23mm. Overall adverse event rate was 9.3% (n = 34/367): 10 patients (2.7 %) required emergency surgery for five delayed and two immediate perforations and three cases of appendicitis.Conclusion eFTR is an effective and relatively safe en bloc resection technique for complex colorectal lesions with the potential to avoid surgery. Further studies assessing the role of eFTR in early CRC treatment with long-term outcomes are needed.
AB - Background Endoscopic full-thickness resection (eFTR) is a minimally invasive resection technique that allows definite diagnosis and treatment for complex colorectal lesionsMethods Consecutive patients undergoing eFTR in 20 hospitals were prospectively included. The primary outcome was technical success, defined as macroscopic complete en bloc resection. Secondary outcomes were: clinical success, defined as tumor-free resection margins (R0 resection); full-thickness resection rate; and adverse events.Results Between July 2015 and October 2018, 367 procedures were included. Indications were difficult polyps (non-lifting sign and/or difficult location; n = 133), primary resection of suspected T1 colorectal cancer (CRC; n = 71), reresection after incomplete resection of T1 CRC (n = 150), and subepithelial tumors (n = 13). Technical success was achieved in 308 procedures (83.9%). In 21 procedures (5.7 %), eFTR was not performed because the lesion could not be reached or retracted into the cap. In the remaining 346 procedures, R0 resection was achieved in 285 (82.4%) and full-thickness resection in 288 (83.2%). The median diameter of resected specimens was 23mm. Overall adverse event rate was 9.3% (n = 34/367): 10 patients (2.7 %) required emergency surgery for five delayed and two immediate perforations and three cases of appendicitis.Conclusion eFTR is an effective and relatively safe en bloc resection technique for complex colorectal lesions with the potential to avoid surgery. Further studies assessing the role of eFTR in early CRC treatment with long-term outcomes are needed.
KW - SUBMUCOSAL DISSECTION
KW - ADVERSE EVENTS
KW - NEOPLASMS
KW - METAANALYSIS
KW - OUTCOMES
KW - CANCER
KW - EMR
U2 - 10.1055/a-1176-1107
DO - 10.1055/a-1176-1107
M3 - Article
C2 - 32498100
SN - 0013-726X
VL - 52
SP - 1014
EP - 1023
JO - Endoscopy
JF - Endoscopy
IS - 11
ER -