scholarly journals Endoscopic full-thickness resection of early colorectal neoplasms using an endoscopic submucosal dissection knife: a retrospective multicenter study

2020 ◽  
Vol 08 (05) ◽  
pp. E611-E616 ◽  
Author(s):  
Marie-Anne Guillaumot ◽  
Maximilien Barret ◽  
Jérémie Jacques ◽  
Romain Legros ◽  
Mathieu Pioche ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Colorectal Neoplasms ◽  
Endoscopic Resection ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Gastrointestinal Neoplasms ◽  
R0 Resection ◽  
Full Thickness ◽  
Submucosal Dissection ◽  
Endoscopic Full Thickness Resection

Abstract Background and study aims Endoscopic full-thickness resection allows resection of early gastrointestinal neoplasms not amenable to conventional endoscopic resection techniques, due to their location, presence of submucosal fibrosis, or suspected deep mural invasion. It is typically achieved using a dedicated over-the-scope device (full-thickness resection device or FTRD). The aim of our study was to evaluate the feasibility, safety, and clinical outcomes of endoscopic full-thickness resection using an endoscopic submucosal dissection (ESD) knife. Patients and methods Consecutive patients who underwent full-thickness endoscopic resection at six tertiary care centers from August 2010 to June 2017 were retrospectively included. We conducted a comparative analysis of patient characteristics, technical success, adverse events, and time to discharge between patients treated by a full-thickness resection using an ESD knife. Results Twenty-one procedures were performed using an ESD knife. En-bloc resection and R0 resection rates were 95.2 % and 65 %, respectively. Clinical symptoms of perforation occurred in 66.7 %. There was no need for surgery or additional endoscopic procedures. Conclusion Endoscopic full-thickness resection of early colorectal neoplasms using an ESD knife might be feasible and safe. It allows complete resection of lesions with no limitation in size. The technique may be preferable to an other-the-scope resection device in lesions larger than 20 mm, and to surgery in selected cases of low-risk T1 colorectal carcinomas, non-lifting adenomas, submucosal tumors, or technically challenging lesion locations.

scholarly journals Clinical Practice of Endoscopic Submucosal Dissection for Early Colorectal Neoplasms by a Colonoscopist with Limited Gastric Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Wen-Hsin Hsu ◽  
Meng-Shun Sun ◽  
Hoi-Wan Lo ◽  
Ching-Yang Tsai ◽  
Yu-Jou Tsai
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Colorectal Neoplasms ◽  
R0 Resection ◽  
En Bloc ◽  
Delayed Bleeding ◽  
Submucosal Dissection ◽  
Limited Experience ◽  
Mean Size ◽  
Delayed Perforation ◽  
The Mean

Objectives. Endoscopic submucosal dissection (ESD) for early colorectal neoplasms is regarded as a difficult technique and should commence after receiving the experiences of ESD in the stomach. The implementation of colorectal ESD in countries where early gastric cancer is uncommon might therefore be difficult. The aim is to delineate the feasibility and the learning curve of colorectal ESD performed by a colonoscopist with limited experience of gastric ESD.Methods. The first fifty cases of colorectal ESD, which were performed by a single colonoscopist between July 2010 and April 2013, were enrolled.Results. The mean of age was 64 (±9.204) years with mean size of neoplasm at 33 (±12.63) mm. The mean of procedure time was 70.5 (±48.9) min. The rates ofen blocresection, R0 resection, and curative resection were 86%, 86%, and 82%, respectively. Three patients had immediate perforation, but no patient developed delayed perforation or delayed bleeding.Conclusion. Our result disclosed that it is feasible for colorectal ESD to be performed by a colonoscopist with little experience of gastric ESD through satisfactory training and adequate case selection.

scholarly journals Resection of a Nonampullary Adenoma with the New Gastroduodenal Full-Thickness Resection Device

2020 ◽  
Vol 11 (03) ◽  
pp. 242-244
Author(s):  
Maximilian Gericke ◽  
Matthias Mende ◽  
Dirk Hartmann ◽  
Siegbert Faiss
Keyword(s):  
Gastrointestinal Tract ◽  
Surgical Resection ◽  
Endoscopic Resection ◽  
Significant Risk ◽  
R0 Resection ◽  
High Morbidity ◽  
Full Thickness ◽  
Endoscopic Full Thickness Resection ◽  
Upper Gastrointestinal ◽  
Subepithelial Tumors

Abstract Introduction Surgical resection of adenomas or subepithelial tumors in the duodenum has a high morbidity compared with endoscopic resection which also has a significant risk of complication. Endoscopic full-thickness resection has shown its feasibility and safety in the colorectum and in the upper gastrointestinal tract. Patient and Methods We present the new gastroduodenal full-thickness resection device (FTRD) for full-thickness resection in a patient with a recurrent nonlifting adenoma in the nonampullary duodenum. Results The procedure was successful with R0 resection without major complications. A control gastroscopy showed no recurrence of the adenoma. Conclusion The gastroduodenal FTRD seems to be a promising new technique for resecting nonlifting adenomas in the nonampullary duodenum.

scholarly journals Hybrid Push-Pull Endoscopic and Laparoscopic Full Thickness Resection for the Minimally Invasive Management of Gastrointestinal Stromal Tumors: A Pilot Clinical Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Field F. Willingham ◽  
Paul Reynolds ◽  
Melinda Lewis ◽  
Andrew Ross ◽  
Shishir K. Maithel ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Endoscopic Resection ◽  
Gastrointestinal Stromal Tumors ◽  
Wedge Resection ◽  
Tertiary Care ◽  
R0 Resection ◽  
Full Thickness ◽  
Stromal Tumors ◽  
Gastric Gists ◽  
Deep Margin

Background. Gastric gastrointestinal stromal tumors (GISTs) that are predominantly endophytic or in anatomically complex locations pose a challenge for laparoscopic wedge resection; however, endoscopic resection can be associated with a positive deep margin given the fourth-layer origin of the tumors.Methods. Patients at two tertiary care academic medical centers with gastric GISTs in difficult anatomic locations or with a predominant endophytic component were considered for enrollment. Preoperative esophagogastroduodenoscopy (EGD), endoscopic ultrasound (EUS) with or without fine needle aspiration (FNA), and cross-sectional imaging were performed. Eligible patients were offered and consented for hybrid and standard management.Results. Over ten months, four patients in two institutions with anatomically complex or endophytic GISTs underwent successful, uncomplicated push-pull hybrid procedures. GIST was confirmed in all resection specimens.Conclusion. In a highly selected population, the hybrid push-pull approach was safe and effective in the removal of complex gastric GISTs. Endoscopic resection alone was associated with a positive deep margin, which the push-pull technique manages with a laparoscopic, full thickness, R0 resection. This novel, minimally invasive, hybrid laparoscopic and endoscopic push-pull technique is a safe and feasible alternative in the management of select GISTs that are not amenable to standard laparoscopic resection.

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