Endoscopy 2018; 50(04): S103-S104
DOI: 10.1055/s-0038-1637335
ESGE Days 2018 ePoster Podium presentations
20.04.2018 – FTRD
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC FULL-THICKNESS RESECTION (EFTR) IN THE LOWER GASTROINTESTINAL TRACT – WHICH PATIENTS BENEFIT THE MOST?

Authors

  • H Albrecht

    1   Klinikum Neumarkt, Department of Medicine II, Neumarkt, Germany

  • M Raithel

    2   Waldkrankenhaus St. Marien, Dept. of Medicine II, Erlangen, Germany

  • A Stegmaier

    3   Stadtkrankenhaus Schwabach, Dept. of Internal Medicine, Schwabach, Germany

  • A Hagel

    4   Praxisklinik Schwabach, Schwabach, Germany

  • C Schäfer

    1   Klinikum Neumarkt, Department of Medicine II, Neumarkt, Germany
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

The endoscopic full-thickness resection (EFTR) significantly expands the spectrum of possible endoscopic resection methods for lesions that show no lifting, submucosal lesions and mucosal carcinomas. Aim of this study was the analysis of the patients, the histopathological results of the resected lesions, the presentation of the clinical results and the effects on the course of the patients.

Methods:

This multicenter study included 55 patients who were admitted to three reference centers between November 2014 and February 2017. The EFTR was conducted according to the standard indications using the FTRD System (OVESCO, Tübingen, Germany).

Results:

In six patients EFTR was not feasible for various reasons. Of the remaining 49 patients, 21 presented with recurrence adenomas and 21 with high grade intraepithelial neoplasia or mucosal carcinoma. Six neuroendocrine tumors (NETs) and one metastasis of a malignant melanoma could be found. Of all lesions (size 2.5 +/- 2 cm) 38 (77.6%) were found to be R0. 11 (22.4%) were R1/2. In eight cases a surgical resection after performance of EFTR was necessary. Also three patients showed lymphatic infiltration causing a following operation. Complications (minor and major) were as follows: one clinically relevant bleeding that could be treated endoscopically, one termination of the procedure because of technical problems (the tissue could not be drawn into the resection-cap) and one perforation in the sigmoid colon which was treated with an over-the-scope-clip (OTSC, OVESCO, Tübingen, Germany).

Conclusions:

Altogether our data show that in over two-thirds of the patients presenting with e.g. non-lifting sign, advanced histopathological findings or submucosal lesions a subsequent surgical procedure can be avoided using the EFTR. But it is of utmost importance to choose the right indications for EFTR because big lesions (> 4 cm) may not fit into the resection cap and in cases of mucosal carcinomas lymphatic invasion may be present.