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Endoscopic full-thickness resection (eFTR) of colorectal lesions: results from the Dutch colorectal eFTR registry.

Abstract：

BACKGROUND:Endoscopic full-thickness resection (eFTR) is a minimally invasive resection technique that allows definite diagnosis and treatment for complex colorectal lesions ≤ 30 mm unsuitable for conventional endoscopic resection. This study reports clinical outcomes from the Dutch colorectal eFTR registry. METHODS: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), re-resection 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 23 mm. 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.

journal_name

Endoscopy

journal_title

Endoscopy

authors

Zwager LW,Bastiaansen BAJ,Bronzwaer MES,van der Spek BW,Heine GDN,Haasnoot KJC,van der Sluis H,Perk LE,Boonstra JJ,Rietdijk ST,Wolters HJ,Weusten BLAM,Gilissen LPL,Ten Hove WR,Nagengast WB,Bekkering FC,Schwartz MP,Terha

doi

10.1055/a-1176-1107

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

1014-1023

issue

11

eissn

0013-726X

issn

1438-8812

journal_volume

52

pub_type

临床试验,杂志文章

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