CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(05): E611-E616
DOI: 10.1055/a-1127-3092
Original article

Endoscopic full-thickness resection of early colorectal neoplasms using an endoscopic submucosal dissection knife: a retrospective multicenter study

Marie-Anne Guillaumot
1  Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hopitaux de Paris, and University of Paris, France
,
Maximilien Barret
1  Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hopitaux de Paris, and University of Paris, France
,
Jérémie Jacques
2  Department of Gastroenterology, Limoges University Hospital, Limoges, France
,
Romain Legros
2  Department of Gastroenterology, Limoges University Hospital, Limoges, France
,
Mathieu Pioche
3  Department of Gastroenterology, Edouard Herriot Hospital, Lyon, France
,
Jérome Rivory
3  Department of Gastroenterology, Edouard Herriot Hospital, Lyon, France
,
Gabriel Rahmi
4  Department of Gastroenterology and Digestive Endoscopy, Georges Pompidou European Hospital, Assistance Publique – Hopitaux de Paris, and University of Paris, France
,
Vincent Lepilliez
5  Department of Gastroenterology, Ramsay Générale de Santé, Hôpital Privé Jean Mermoz, Lyon, France
,
Edouard Chabrun
6  Department of Endoscopy and Gastroenterology, Bordeaux University Hospital, Bordeaux, France
,
Sarah Leblanc
1  Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hopitaux de Paris, and University of Paris, France
,
Stanislas Chaussade
1  Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique – Hopitaux de Paris, and University of Paris, France
› Author Affiliations
  

Abstract

Background and study aims Endoscopic full-thickness resection allows resection of early gastrointestinal neoplasms not amenable to conventional endoscopic resection techniques, due to their location, presence of submucosal fibrosis, or suspected deep mural invasion. It is typically achieved using a dedicated over-the-scope device (full-thickness resection device or FTRD). The aim of our study was to evaluate the feasibility, safety, and clinical outcomes of endoscopic full-thickness resection using an endoscopic submucosal dissection (ESD) knife.

Patients and methods Consecutive patients who underwent full-thickness endoscopic resection at six tertiary care centers from August 2010 to June 2017 were retrospectively included. We conducted a comparative analysis of patient characteristics, technical success, adverse events, and time to discharge between patients treated by a full-thickness resection using an ESD knife.

Results Twenty-one procedures were performed using an ESD knife. En-bloc resection and R0 resection rates were 95.2 % and 65 %, respectively. Clinical symptoms of perforation occurred in 66.7 %. There was no need for surgery or additional endoscopic procedures.

Conclusion Endoscopic full-thickness resection of early colorectal neoplasms using an ESD knife might be feasible and safe. It allows complete resection of lesions with no limitation in size. The technique may be preferable to an other-the-scope resection device in lesions larger than 20 mm, and to surgery in selected cases of low-risk T1 colorectal carcinomas, non-lifting adenomas, submucosal tumors, or technically challenging lesion locations.



Publication History

Received: 21 August 2019

Accepted: 23 January 2020

Publication Date:
17 April 2020 (online)

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