G Andrisani1, P Soriani2, M Manno2, M Pizzicannella3, F Pugliese4, M Mutignani4, R Naspetti5, L Petruzziello6, F Iacopini7, C Grossi7, P Lagoussis8, S Vavassori8, F Coppola9, A La Terra9, S Ghersi10, P Cecinato11, G De Nucci12, R Salerno13, M Pandolfi3, G Costamagna6, F M Di Matteo3. 1. Digestive Endoscopy Unit, Campus Bio-Medico, Rome, Italy. Electronic address: gianluca.andrisani@gmail.com. 2. Digestive Endoscopy Unit, Ramazzini Hospital, Carpi, Modena, Italy. 3. Digestive Endoscopy Unit, Campus Bio-Medico, Rome, Italy. 4. Diagnostic and Interventional Digestive Endoscopy, Niguarda Ca-Granda Hospital, Milan, Italy. 5. Surgical Endoscopy Unit, Careggi Hospital, Florence, Italy. 6. Digestive Endoscopy Unit, Gemelli University Hospital, Rome, Italy. 7. Gastroenterology Endoscopy Unit, S.Giuseppe Hospital, Albano Laziale, Rome,Italy. 8. Division Of General Surgery I, IRCCS Policlinico San Donato, San Donato Milanese, Italy. 9. Department Gastroenterology, San Giovanni Bosco Hospital, Torino, Italy. 10. Gastroenterology and Digestive Endoscopy Unit, AUSL Bologna, Bologna, Italy. 11. Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. 12. Gastroenterology and Digestive Endoscopy Unit, A.O. Salvini, Garbagnate Milanese, Italy. 13. Endoscopy Unit, ASST Fatebenefratelli Sacco, Milan, Italy.
Abstract
BACKGROUND AND AIM: Endoscopic full-thickness resection(EFTR) with FTRD® in colo-rectum may be useful for several indications.The aim was to assess its efficacy and safety. MATERIAL AND METHODS: In this retrospective multicenter study 114 patients were screened; 110 (61M/49F, mean age 68 ± 11 years, range 20-90) underwent EFTR using FTRD®. Indications were:residual/recurrent adenoma (39), incomplete resection at histology (R1 resection) (26), non-lifting lesion (12), adenoma involving the appendix (2) or diverticulum (2), subepithelial lesions(10), suspected T1 carcinoma (16), diagnostic resection (3). Technical success (TS: lesion reached and resected), R0 resection (negative lateral and deep margins),EFTR rate(all layers documented in the specimen) and safety have been evaluated. RESULTS: TS was achieved in 94.4% of cases. EFTR was achieved in 91% with lateral and deep R0 resection in 90% and 92%. 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) and high-grade dysplasia (HGD) (3), scar tissue (1). Histology reports of R1 resections were: adenoma with LGD (6), with HGD (1), low-risk (6) and high-risk (1) T1, scar tissue (12). Non-lifting lesions were diagnosed as: adenoma with HGD (3), low-risk (7) and high risk (2) T1. Adverse clinical events occurred in 12 patients (11%),while adverse technical events in11%. Three-months follow-up was available in 100 cases and residual disease was evident in only seven patients. CONCLUSIONS: EFTR using FTRD® seems to be a feasible, effective and safe technique for treating selected colo-rectal lesions. Comparative prospective studies are needed to confirm these promising results.
BACKGROUND AND AIM: Endoscopic full-thickness resection(EFTR) with FTRD® in colo-rectum may be useful for several indications.The aim was to assess its efficacy and safety. MATERIAL AND METHODS: In this retrospective multicenter study 114 patients were screened; 110 (61M/49F, mean age 68 ± 11 years, range 20-90) underwent EFTR using FTRD®. Indications were:residual/recurrent adenoma (39), incomplete resection at histology (R1 resection) (26), non-lifting lesion (12), adenoma involving the appendix (2) or diverticulum (2), subepithelial lesions(10), suspected T1 carcinoma (16), diagnostic resection (3). Technical success (TS: lesion reached and resected), R0 resection (negative lateral and deep margins),EFTR rate(all layers documented in the specimen) and safety have been evaluated. RESULTS: TS was achieved in 94.4% of cases. EFTR was achieved in 91% with lateral and deep R0 resection in 90% and 92%. 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) and high-grade dysplasia (HGD) (3), scar tissue (1). Histology reports of R1 resections were: adenoma with LGD (6), with HGD (1), low-risk (6) and high-risk (1) T1, scar tissue (12). Non-lifting lesions were diagnosed as: adenoma with HGD (3), low-risk (7) and high risk (2) T1. Adverse clinical events occurred in 12 patients (11%),while adverse technical events in11%. Three-months follow-up was available in 100 cases and residual disease was evident in only seven patients. CONCLUSIONS: EFTR using FTRD® seems to be a feasible, effective and safe technique for treating selected colo-rectal lesions. Comparative prospective studies are needed to confirm these promising results.
Authors: Irmengard Krutzenbichler; Markus Dollhopf; Helmut Diepolder; Andreas Eigler; Martin Fuchs; Simon Herrmann; Gerhard Kleber; Björn Lewerenz; Christoph Kaiser; Tilman Lilje; Timo Rath; Ayman Agha; Francesco Vitali; Claus Schäfer; Wolfgang Schepp; Felix Gundling Journal: Surg Endosc Date: 2020-07-09 Impact factor: 4.584