Technical success (lesion reached and resected) was achieved in 94.4 %. R0 resection was achieved on lateral and deep margins in 90 % and 92 %, respectively. Major complications (requiring surgical treatment) occurred in 1.8 %.
Andrisani G et al., University Campus Bio-Medico, Rome, Italy, reported on 110 patients (61m/49f, mean age 68±11 years, range 20-90) from 12 Italian endoscopy centers who underwent EFTR using the FTRD System. Indications were: residual/recurrent adenoma (39), incomplete resection at histology (26), non-lifting lesion (12), adenoma involving the appendix (2) or diverticulum (2), subepithelial lesions (10), suspected T1 carcinoma (16), and diagnostic resection (3).
Technical success (lesion reached and resected) was achieved in 94.4 % of cases. R0 resection was achieved on lateral and deep margins in 90 % and 92 %, respectively. Mean size of specimens was 20 mm (range 6-42). In residual/recurrent adenomas, final analysis revealed: low-risk T1 (11), adenoma with low-grade dysplasia (LGD) (24) adenoma with high-grade dysplasia (HGD) (3), scar tissue (1). Histology reports of R1 resections were: adenoma with LGD (6), adenoma with HGD (1), low-risk T1 (6) and high-risk T1 (1), scar tissue (12). Non-lifting lesions were diagnosed as: adenoma with HGD (3), low-risk T1 (7) and high risk T1 (2). Adverse events occurred in 12 patients (11 %), 2 patients (1.8 %) required further surgical treatment: In one patient, stenosis of the sigmoid colon occurred after clip deployment and had to be finally treated surgically after post-dilation perforation. One of 2 patients with resection involving the appendix developed acute appendicitis and underwent surgery. Three-months follow-up was available in all patients and revealed residual disease in 7 patients (6.4 %).
The authors concluded that EFTR using the FTRD System is a feasible, effective and safe technique for the treatment of different high-risk colorectal lesions.
Colo-rectal endoscopic full-thickness resection (EFTR) with the over-the-scope device (FTRD): A multicentre Italian experience.
Andrisani G, Soriani P, Manno M, Pizzicannella M, Pugliese F, Mutignani M, Naspetti R, Petruzziello L, Iacopini F, Grossi C, Lagoussis P, Vavassori S, Coppola F, La Terra A, Ghersi S, Cecinato P, De Nucci G, Salerno R, Pandolfi M, Costamagna G, Di Matteo FM.
Digestive and Liver Disease 2019; 51:375-381.