Valli and colleagues, Division of Gastroenterology and Hepatology, Zurich University Hospital, Switzerland, reported about their data on the colonic FTRD® between June 2012 and October 2016. Full-thickness resection in the colorectum (52) and off-label use in the upper GI (8) were performed in 60 patients with the following indications: recurrent and primary non-lifting adenomas, combined procedure of EMR and EFTR in large polyps (EFTR for non-lifting area), primary and re-resection of T1 tumors not suitable for surgical resection, submucosal lesions and adenomas at difficult locations (appendix base, diverticulum).
The overall technical success rate was 97 % (58/60), the overall R0 and full-thickness resection rates were 79 % and 88 % respectively. Clinical success was shown to be even better (88 %) based on follow-up histology. In median a procedure took 60 minutes with a mean resection size of 24 mm. The adverse event rate was 7 %. One patient (2 %) developed appendicitis after resection at the appendix base and needed surgical appendectomy. All other complications (minor bleeding, perforation due to accidental lack of clip deployment) were treated endoscopically. The data corresponds with the results of the Wall Resect trial.
The authors conclude that EFTR with the colonic FTRD® is safe and feasible with respective prior training. It enables endoscopic resection of all gut layers with low risk of severe adverse events. EFTR with the FTRD® shows also an alternative procedure to surgery for lesions that were previously not endoscopically resectable.
Safe and successful resection of difficult GI lesions using a novel single-step full-thickness resection device (FTRD®)
Valli P.V., Mertens J., Bauerfeind P.
Surg Endosc. 2017 Jun 29. doi: 10.1007/s00464-017-5676-9