The FTRD® System is a useful tool for R0 resection of complex recurrent / residual colorectal neoplasia

EFTR in 30 patients with recurrent / residual colorectal neoplasia led to R0 resection in 24 patients (80 %) with an acceptable complication rate given the complexity of the resected lesions.

A. von Helden et al., Community Hospital Bonn, Academic Teaching Hospital of the University of Bonn, Germany, published a case series of 30 consecutive EFTR interventions on small (<20 mm), difficult to resect, recurrent/residual colorectal neoplastic lesions.

Endoscopic mucosal resection (EMR) in piecemeal technique is the treatment standard for larger flat or sessile colorectal lesions. The method is burdened by a high recurrence rate mostly presenting as difficult to resect lesions. In these situations, endoscopic full-thickness resection with the FTRD System offers the option of complete resection.

In the study, EFTR was technically feasible in 28/30 patients (93.3 %). The R0 resection rate was 80 % (24/30) and the median procedure time was 34.5 min (range: 11-120 minutes). After the first 15 procedures, the per-protocol rate increased from 13/15 to 15/15 and the R0 resection rate increased from 9/15 (69.2 %) to 15/15 (100 %, p<0.01). One patient suffered from a delayed perforation the day after the procedure and needed emergency surgery. Minor bleeding occurred in 3/28 patients and post-interventional fever in one patient. The 30-day mortality rate was 0 %.

The authors concluded that EFTR with the FTRD System is a useful method for endoscopic resection of difficult to treat recurrent or residual colorectal neoplasias. High R0 resection rates were observed after a relatively short learning curve. The complication rate seems acceptable given the complexity of the resected lesions.

Endoscopic full-thickness resectin using an over-the-scope device for treatment of recurrent / residual colorectal neoplasia: a single-center case series.
Von Helden A, Hildenbrand R, Sido B, Dumoulin FL.
BMC Gastroenterology 2019;19:121; DOI: