Endoscopy 2019; 51(04): S168-S169
DOI: 10.1055/s-0039-1681668
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 10:30 – 11:00: Colon: resection 7 ePoster Podium 2
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC FULL THICKNESS RESECTION OF COLORECTAL LESIONS WITH THE FULL THICKNESS RESECTION DEVICE: CLINICAL EXPERIENCE FROM TWO REFERRAL CENTERS IN GREECE

M Velegraki
1   Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
,
A Trikola
2   Department of Gastroenterology, Athens Naval Hospital, Athens, Greece
,
K Vasiliadis
2   Department of Gastroenterology, Athens Naval Hospital, Athens, Greece
,
M Fragaki
1   Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
,
A Mpitouli
1   Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
,
I Dimas
1   Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
,
E Giannikaki
3   Department of Histopathology, Venizeleio General Hospital, Heraklion, Greece
,
A Kapranou
4   Department of Histopathology, Athens Naval Hospital, Athens, Greece
,
A Kordelas
4   Department of Histopathology, Athens Naval Hospital, Athens, Greece
,
G Stefanidis
2   Department of Gastroenterology, Athens Naval Hospital, Athens, Greece
,
GA Paspatis
1   Department of Gastroenterology, Venizeleio General Hospital, Heraklion, Greece
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Endoscopic full thickness resection (EFTR) is a novel invasive treatment for colorectal lesions not resectable by conventional endoscopic techniques. This study is the first report of clinical experience with the Full Thickness Resection Device (FTRD) among referral centers in Greece, assessing EFTR efficacy and safety.

Methods:

We conducted a retrospective analysis of the first 15 patients treated with FTRD in Greece from October 2015 through September 2018. The indications included difficult adenomas (non-lifting and/or at difficult locations), early adenocarcinomas and subepithelial tumors. Primary endpoints were technical success (macroscopically complete, en bloc resection) and R0 resection (histologically complete resection).

Results:

Technical success and R0 resection were achieved in 12 of 15 procedures (80%). In 7 patients with difficult adenomas, technical success and R0 resection occurred in 85.7%. In the subgroup with carcinomas (n = 3), technical success and R0 resection rate was 66.6% while in the subgroup with subepithelial tumors (n = 5) the rate was 80%. In general, technical success and R0 resection were decreased significantly for lesions > 20 mm vs. ≤20 mm (33.3% vs. 91.6%) and/or localized in the rectum vs. distal and proximal colon (50% vs. 84.6%). No significant difference was observed between the lesions previously treated endoscopically and the ones non-treated. In 15 patients a total of three adverse events occurred (20%). One of the patients underwent laparoscopic appendectomy due to EFTR around the appendix. Recurrent abdominal pain of unknown cause and minor bleeding were additionally observed in 2 patients.

Conclusions:

Our study showed favorable results concerning EFTR feasibility, efficacy and safety among Greek patients, especially for lesions ≤20 mm and/or localized in distal and proximal colon. Technical success, R0 resection and adverse events rates are comparable with data reported in literature. Further larger studies are needed to define the clinical benefit and long-term outcomes of EFTR in selected patients.