THE USE OF GASTRODUODENAL FULL THICKNESS RESECTION DEVICE (FTRD) FOR THE TREATMENT OF UPPER GASTROINTESTINAL LESIONS. A CASE SERIES FROM A GREEK TERTIARY HOSPITAL

Aims Endoscopic full-thickness resection (EFTR) of upper gastrointestinal tract lesions using the gastroduodenal FTRD^​ is an innovative treatment for gastric wall tumors. We aimed to present our experience assessing the efficacy and safety of FTRD.

Methods 5 patients (4 male, mean age 60±5 years) with submucosal lesions, mean size 13 (10-16) mm, in the antrum and corpus of the stomach were included. The process begins by marking the lesion and FTRD is mounted onto a gastroscope with a 3,7mm working channel. The insertion of the device in the esophageal lumen is facilitated by dilation with a 20x60mm balloon catheter, which is successfully removed. The grasper enables the complete insertion of the lesion into the FTRD cap and the clip is released. After successful clip deployment, resection is performed with the incorporated snare.

Results Technical success and R0 resection were achieved in all patients (100%) with a mean procedural time of 23 min. Bleeding was occurred in one patient that was successfully treated with APC (Argon Plasma Coagulation) application. No major adverse events noted. Patients did not require hospitalization or further intervention. Histopathological analysis confirmed R0 resection in all patients and established a definite diagnosis of a gastrointestinal stromal tumor in 3 patients, a neuroendocrine tumor and ectopic pancreas in two other patients.

Conclusions Gastroduodenal EFTR may serve as a minimally invasive, safe, effective endoscopic method for the treatment of small subepithelial tumors. Further studies are needed in order to evaluate the clinical benefit and long-term outcome of EFTR in selected patients.

 

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Publication History

Article published online:
14 April 2022