scholarly journals Efficacy and safety of gastric exposed endoscopic full-thickness resection without laparoscopic assistance: a systematic review

2020 ◽  
Vol 08 (09) ◽  
pp. C4-C4
Author(s):  
Antonino Granata ◽  
Alberto Martino ◽  
Michele Amata ◽  
Dario Ligresti ◽  
Fabio Tuzzolino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Full Thickness ◽  
Efficacy And Safety ◽  
Endoscopic Full Thickness Resection ◽  
Laparoscopic Assistance

scholarly journals Efficacy and safety of gastric exposed endoscopic full-thickness resection without laparoscopic assistance: a systematic review

2020 ◽  
Vol 08 (09) ◽  
pp. E1173-E1182
Author(s):  
Granata Antonino ◽  
Martino Alberto ◽  
Amata Michele ◽  
Ligresti Dario ◽  
Tuzzolino Fabio ◽  
...  
Keyword(s):  
Complete Resection ◽  
Abdominal Abscess ◽  
Full Thickness ◽  
Efficacy And Safety ◽  
Delayed Bleeding ◽  
Abdominal Infection ◽  
Endoscopic Full Thickness Resection ◽  
Delayed Perforation ◽  
Laparoscopic Assistance ◽  
Major Adverse Events

Abstract Background and study aims Exposed endoscopic full-thickness resection (Eo-EFTR) without laparoscopic assistance is a minimally invasive natural orifice transluminal endoscopic surgery (NOTES) technique that has shown promising efficacy and safety in resection of gastric submucosal tumors (G-SMTs) arising from muscularis propria (MP). However, data on the efficacy and safety of gastric Eo-EFTR mostly come from relatively small retrospective studies and concern regarding its use still exists. The aim of our systematic review was to assess the efficacy and safety of gastric Eo-EFTR without laparoscopic assistance. Methods A detailed MEDLINE and EMBASE search was performed for papers published from January 1998 to November 2019 and reporting on gastric Eo-EFTR without laparoscopic assistance. The search strategy used the terms “endoscopic full thickness resection” and “gastric” or “stomach”. The primary outcomes were complete resection and surgical conversion rates. The secondary outcomes were overall major adverse events, delayed bleeding, delayed perforation, peritonitis, abdominal abscess and/or abdominal infection and successful Eo-EFTR. Results Fifteen Asian studies were included in our final review, providing data on 750 Eo-EFTR-treated G-SMTs. The per-lesion rate of complete resection and surgical conversion were 98.8 %\0.8 %, respectively. The per-lesion rate of major adverse events, delayed bleeding, delayed perforation and peritonitis, abdominal abscess and/or abdominal infection was 1.6 %\0.5 %\0.1 %\0.9 %, respectively. The per-lesion rate of successful Eo-EFTR (i. e. complete tumor resection and effective endoscopic defect closure) was 98.3 %. Conclusions Eo-EFTR without laparoscopic assistance appears to be highly effective and safe NOTES for removing deep G-SMTs, particularly those arising from MP layer.

A systematic review regarding the feasibility and safety of endoscopic full thickness resection (EFTR) for colonic lesions

2013 ◽  
Vol 27 (10) ◽  
pp. 3520-3529 ◽  
Author(s):  
Adela Brigic ◽  
Nicholas R. A. Symons ◽  
Omar Faiz ◽  
Chris Fraser ◽  
Susan K. Clark ◽  
...  
Keyword(s):  
Systematic Review ◽  
Full Thickness ◽  
Endoscopic Full Thickness Resection

scholarly journals PTU-017 Systematic Review of Endoscopic full Thickness Resection (Eftr) Techniques for Colonic Lesions: Abstract PTU-017 Table 1

Gut ◽  
2013 ◽  
Vol 62 (Suppl 1) ◽  
pp. A48.2-A49
Author(s):  
A Brigic ◽  
N R A Symons ◽  
O Faiz ◽  
C Fraser ◽  
S K Clark ◽  
...  
Keyword(s):  
Systematic Review ◽  
Full Thickness ◽  
Endoscopic Full Thickness Resection

Efficacy and Safety of Endoscopic Full-Thickness Resection in the Colorectum: Results From the German Colonic FTRD Registry

2020 ◽  
Vol 115 (12) ◽  
pp. 1998-2006 ◽  
Author(s):  
Benjamin Meier ◽  
Bettina Stritzke ◽  
Armin Kuellmer ◽  
Philipp Zervoulakos ◽  
Georg Hermann Huebner ◽  
...  
Keyword(s):  
Full Thickness ◽  
Efficacy And Safety ◽  
Endoscopic Full Thickness Resection

Systematic review and meta-analysis on effectiveness and safety of the full-thickness resection device (FTRD) in the colon

2021 ◽  
Author(s):  
Andreas Wannhoff ◽  
Benjamin Meier ◽  
Karel Caca
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Emergency Surgery ◽  
Meta Analysis ◽  
Target Lesion ◽  
Complete Resection ◽  
Full Thickness ◽  
Endoscopic Full Thickness Resection ◽  
Estimate Rate ◽  
Conference Papers

Abstract Background Endoscopic full-thickness resection (EFTR) has expanded the possibilities of endoscopic resection. The full-thickness resection device (FTRD, Ovesco Endoscopy, Tübingen, Germany) combines a clip-based defect closure and snare resection in a single device. Methods Systematic review and meta-analysis on effectiveness and safety of the FTRD in the colon. Results A total of 26 studies (12 published as full-text articles and 14 conference papers) with 1538 FTRD procedures were included. The pooled estimate for reaching the target lesion was 96.1 % (95 % confidence interval [95 % CI]: 94.6–97.1) and 90.0 % (95 % CI: 87.0–92.3) for technically successful resection. Pooled estimate of histologically complete resection was 77.8 % (95 % CI: 74.7–80.6). Adverse events occurred at a pooled estimate rate of 8.0 % (95 % CI: 5.8–10.4). Pooled estimates for bleeding and perforation were 1.5 % (95 % CI: 0.3–3.3) and 0.3 % (95 % CI: 0.0–0.9), respectively. The rate for need of emergency surgery after FTRD was 1.0 % (95 % CI: 0.4–1.8). Conclusion The use of the FTRD in the colon shows very high rates of technical success and complete resection (R0) as well as a low risk of adverse events. Emergency surgery after colonic FTRD resection is necessary in single cases only.

scholarly journals Endoscopic full-thickness resection in the colorectum: a single-center case series evaluating indication, efficacy and safety

2018 ◽  
Vol 06 (10) ◽  
pp. E1227-E1234 ◽  
Author(s):  
Krijn Haasnoot ◽  
Bas van der Spek ◽  
Christof Meischl ◽  
Dimitri Heine
Keyword(s):  
Colorectal Carcinoma ◽  
Adverse Events ◽  
R0 Resection ◽  
Radical Excision ◽  
Full Thickness ◽  
Efficacy And Safety ◽  
Technical Success ◽  
Endoscopic Techniques ◽  
T1 Colorectal Carcinoma ◽  
Endoscopic Full Thickness Resection

Abstract Background and study aims Endoscopic full-thickness resection (eFTR) allows en-bloc and transmural resection of colorectal lesions for which other advanced endoscopic techniques are unsuitable. We present our experience with a novel “clip first, cut later” eFTR-device and evaluate its indications, efficacy and safety. Patients and methods From July 2015 through October 2017, 51 eFTR-procedures were performed in 48 patients. Technical success and R0-resection rates were prospectively recorded and retrospectively analyzed. Results Indications for eFTR were non-lifting adenoma (n = 19), primary resection of malignant lesion (n = 2), resection of scar tissue after incomplete endoscopic resection of low-risk T1 colorectal carcinoma (n = 26), adenoma involving a diverticulum (n = 2) and neuroendocrine tumor (n = 2). Two lesions were treated by combining endoscopic mucosal resection and eFTR. Technical success was achieved in 45 of 51 procedures (88 %). Histopathology confirmed full-thickness resection in 43 of 50 specimens (86 %) and radical resection (R0) in 40 procedures (80 %). eFTR-specimens, obtained for indeterminate previous T1 colorectal carcinoma resection, were free of residual carcinoma in 25 of 26 cases (96 %). In six patients (13 %) a total of eight adverse events occurred within 30 days after eFTR. One perforation occurred, which was corrected endoscopically. No emergency surgery was necessary. Conclusion In this study eFTR appears to be safe and effective for the resection of colorectal lesions. Technical success, R0-resection and major adverse events rate were reasonable and comparable with eFTR data reported elsewhere. Mean specimen diameter (23 mm) limits its use to relatively small lesions. A clinical algorithm for eFTR case selection is proposed. eFTR ensured local radical excision where other endoscopic techniques did not suffice and reduced the need for surgery in selected cases.

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