Full Thickness Resection of Colorectal Lesions. Promising Results From an Observational Study in a Spanish Tertiary Center

Aims Endoscopic full thickness resection (EFTR) with Full thickness resection device (FTRD) allows endoscopic removal of difficult-to-resect colorectal lesions with a simultaneous closure of the wall, minimizing the risk of perforation and allowing “en bloc” resection. In this prospective observational study we aim to analyse the efficacy and safety of EFTR with FTRD in a large tertiary Spanish center.

Methods Prospective observational study from 2016 to 2019 including 21 patients with a mean age of 62.9 years. Indications for EFTR were severe fibrosis, difficult location, suspected T1 carcinoma and subepithelial tumor; all of them less than 35mm. Primary endpoints were technical success, R0 resection and adverse events.

Results Technical success was achieved in 95 % and R0 resection in 80.9 % of the cases. We also included a large lesion successfully removed using a hybrid-EFTR. No major intraprocedural adverse events were registered. Only 3 patients (14.3 %) had to undergo programmed surgery, including 1 case of technical failure and 2 cases of pT1 adenocarcinoma with high risk features. Regarding delayed adverse events, 2 cases (9.5 %) of acute appendicitis were observed 48 hours after appendiceal EFTR and required urgent appendectomy. Endoscopic follow-up with a mean of 14.7 months was performed showing no macro or microscopic recurrence after succesful EFTR.

Tab. 1

Technical success n, N %	20/21 (95.2 %)
R0 resection n, N (%)	17/21 (80.9 %)
Minor intraprocedural adverse events	2/21 (9.5 %)
Delayed adverse events	2/21 (9.5 %)
Follow-up, months, mean (SD)	14.7 (9.3)

Conclusions EFTR is an effective and safe alternative to surgery for difficult to resect colorectal lesions. In the subgroup analysis, fibrosis was not associated with lower R0 rate or higher risk of adverse events. Appendiceal EFTR might associate with an increased risk of AA, and the role of prophylactic antibiotics requires further research.

Fig.1

Citation: Martinez Barco A, Santiago Garcia J, De Frutos Rosa D et al. eP210 FULL THICKNESS RESECTION OF COLORECTAL LESIONS. PROMISING RESULTS FROM AN OBSERVATIONAL STUDY IN A SPANISH TERTIARY CENTER. Endoscopy 2021; 53: S167.

Publication History

Article published online:
19 March 2021