Sa2022 HYBRID TECHNIQUE USING ENDOSCOPIC MUCOSAL RESECTION AND ENDOSCOPIC FULL-THICKNESS RESECTION FOR LARGE COLORECTAL LESIONS: INITIAL NORTH AMERICAN EXPERIENCE

AbstractEndoscopic treatment of large laterally spreading tumors (LSTs) with a focus of submucosally invasive colorectal cancer (T1 CRC) can be challenging. We evaluated outcomes of a hybrid resection technique using piecemeal endoscopic mucosal resection (pEMR) and endoscopic full-thickness resection (eFTR) in patients with large colonic LSTs containing suspected T1 CRC. Six hybrid pEMR-eFTR procedures for T1 CRCs were registered in a nationwide eFTR registry between July 2015 and December 2019. In all cases, the invasive part of the lesion was successfully isolated with eFTR; with eFTR, histologically complete resection of the invasive part was achieved in 5 /6 patients (83.3 %). No adverse events occurred during or after the procedure. The median follow-up time was 10 months (range 6–27), with all patients having undergone ≥ 1 surveillance colonoscopy. One patient had a small adenomatous recurrence, which was removed endoscopically. In conclusion, hybrid pEMR-eFTR is a promising noninvasive treatment modality that seems feasible for a selected group of patients with large LSTs containing a small focus of T1 CRC.

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Non-exposed device-assisted endoscopic full-thickness resection (FTRD) for a challenging colorectal adenoma recurrence after endoscopic mucosal resection using a test cap

Techniques in Coloproctology ◽

10.1007/s10151-020-02295-6 ◽

2020 ◽

Author(s):

V. Zimmer

Keyword(s):

Endoscopic Mucosal Resection ◽

Colorectal Adenoma ◽

Full Thickness ◽

Adenoma Recurrence ◽

Mucosal Resection ◽

Endoscopic Full Thickness Resection ◽

Colorectal Adenoma Recurrence

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Current Endoscopic Resection Techniques for Gastrointestinal Lesions: Endoscopic Mucosal Resection, Submucosal Dissection, and Full-Thickness Resection

Visceral Medicine ◽

10.1159/000515354 ◽

2021 ◽

pp. 1-14

Author(s):

Arthur Hoffman ◽

Raja Atreya ◽

Timo Rath ◽

Markus Ferdinand Neurath

Keyword(s):

Endoscopic Mucosal Resection ◽

Endoscopic Resection ◽

Complication Rates ◽

Full Thickness ◽

National Guidelines ◽

En Bloc ◽

Early Stages ◽

Mucosal Resection ◽

Submucosal Dissection ◽

Gastrointestinal Lesions

Background: Endoscopic resection of dysplastic lesions in early stages of cancer reduces mortality rates and is recommended by many national guidelines throughout the world. Snare polypectomy and endoscopic mucosal resection (EMR) are established techniques of polyp removal. The advantages of these methods are their relatively short procedure times and acceptable complication rates. The latter include delayed bleeding in 0.9% and a perforation risk of 0.4–1.3%, depending on the size and location of the resected lesion. EMR is a recent modification of endoscopic resection. A limited number of studies suggest that larger lesions can be removed en bloc with low complication rates and short procedure times. Novel techniques such as endoscopic submucosal dissection (ESD) are used to enhance en bloc resection rates for larger, flat, or sessile lesions. Endoscopic full-thickness resection (EFTR) is employed for non-lifting lesions or those not easily amenable to resection. Procedures such as ESD or EFTR are emerging standards for lesions inaccessible to EMR techniques. Summary: Endoscopic treatment is now regarded as first-line therapy for benign lesions. Key Message: Endoscopic resection of dysplastic lesions or early stages of cancer is recommended. A plethora of different techniques can be used dependent on the lesions.

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