Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece.

Autor: Velegraki M; Department of Gastroenterology, Venizeleion General Hospital, Heraklion, Crete (Magdalini Velegraki, Maria Fragaki, Afroditi Mpitouli, Ioannis Dimas, Evangelos Voudoukis, Gregorios A. Paspatis)., Trikola A; Department of Gastroenterology, Athens Naval Hospital, Athens (Artemis Trikola, Konstantinos Vasiliadis, Gerasimos Stefanidis)., Vasiliadis K; Department of Gastroenterology, Athens Naval Hospital, Athens (Artemis Trikola, Konstantinos Vasiliadis, Gerasimos Stefanidis)., Fragaki M; Department of Gastroenterology, Venizeleion General Hospital, Heraklion, Crete (Magdalini Velegraki, Maria Fragaki, Afroditi Mpitouli, Ioannis Dimas, Evangelos Voudoukis, Gregorios A. Paspatis)., Mpitouli A; Department of Gastroenterology, Venizeleion General Hospital, Heraklion, Crete (Magdalini Velegraki, Maria Fragaki, Afroditi Mpitouli, Ioannis Dimas, Evangelos Voudoukis, Gregorios A. Paspatis)., Dimas I; Department of Gastroenterology, Venizeleion General Hospital, Heraklion, Crete (Magdalini Velegraki, Maria Fragaki, Afroditi Mpitouli, Ioannis Dimas, Evangelos Voudoukis, Gregorios A. Paspatis)., Voudoukis E; Department of Gastroenterology, Venizeleion General Hospital, Heraklion, Crete (Magdalini Velegraki, Maria Fragaki, Afroditi Mpitouli, Ioannis Dimas, Evangelos Voudoukis, Gregorios A. Paspatis)., Giannikaki E; Department of Histopathology, Venizeleion General Hospital, Heraklion, Crete (Elpida Giannikaki)., Kapranou A; Department of Histopathology, Athens Naval Hospital, Athens (Amalia Kapranou, Athanasios Kordelas), Greece., Kordelas A; Department of Histopathology, Athens Naval Hospital, Athens (Amalia Kapranou, Athanasios Kordelas), Greece., Stefanidis G; Department of Gastroenterology, Athens Naval Hospital, Athens (Artemis Trikola, Konstantinos Vasiliadis, Gerasimos Stefanidis)., Paspatis GA; Department of Gastroenterology, Venizeleion General Hospital, Heraklion, Crete (Magdalini Velegraki, Maria Fragaki, Afroditi Mpitouli, Ioannis Dimas, Evangelos Voudoukis, Gregorios A. Paspatis).
Jazyk: angličtina
Zdroj: Annals of gastroenterology [Ann Gastroenterol] 2019 Sep-Oct; Vol. 32 (5), pp. 482-488. Date of Electronic Publication: 2019 Jun 10.
DOI: 10.20524/aog.2019.0392
Abstrakt: Background: Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD ® ) is an invasive treatment for colorectal lesions not resectable by conventional endoscopic techniques. This study presents the first Greek experience of the FTRD ® procedure, assessing the efficacy and safety of EFTR.
Methods: We conducted a retrospective analysis of 17 consecutive patients treated with the FTRD ® at 2 referral centers from October 2015 through December 2018. The indications included difficult adenomas (non-lifting and/or at difficult locations), early adenocarcinomas and subepithelial tumors. Primary endpoints were technical success and R0 resection.
Results: Technical success and R0 resection were achieved in 82.3% procedures (14/17) and in 87.5% of those with difficult adenomas (8 patients). In the subgroup with carcinomas (n=3), the rate of technical success and R0 resection was 66.6%, while in the subgroup with subepithelial tumors (n=6) the rate was 83.3%. Technical success and R0 resection were significantly lower for lesions >20 mm vs. ≤20 mm (P=0.0429). In the 17 patients a total of 3 adverse events occurred (17.6%) and one of the patients underwent laparoscopic appendectomy because of EFTR around the appendix.
Conclusions: Our study showed favorable results concerning EFTR feasibility, efficacy and safety, especially for lesions ≤20 mm, non-lifting adenomas, and subepithelial tumors. Technical success, R0 resection, and adverse events rates were comparable with previously published data. Larger randomized studies are needed to better define the clinical benefit and long-term outcomes of EFTR in selected patients.
Competing Interests: Conflict of Interest: None
Databáze: MEDLINE
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