scholarly journals Resección endoscópica transmural del colon. Reporte de tres casos

2020 ◽  
Author(s):  
Luis Ernesto Caro ◽  
Sandra Canseco ◽  
Christian Sánchez ◽  
Pablo Hoffman ◽  
María Carolina Bolino
Keyword(s):  
Histopathological Examination ◽  
Plain Film ◽  
Complete Resection ◽  
High Grade ◽  
Defect Closure ◽  
Full Thickness ◽  
Tumor Delineation ◽  
Small Series ◽  
Endoscopic Full Thickness Resection

Introduction. Endoscopic Full-thickness Resection (EFTR) consists of the full-thickness resection of a limited portion of the digestive wall immediately followed by defect closure. This technique has been proposed for the resection of selected lesions not amenable to conventional endoscopic resection. Objective. The aim of this work is to describe the first three cases of colonic EFTR performed in Argentina. Material and methods. Three patients are described, one with a laterally spreading tumor of approximately 35-40 mm (n = 1) and two with an incomplete adenoma resection with a scar and a non-lifting sing (n = 2). After tumor delineation using a marking probe, EFTR was performed using the full thickness resection device (FTRD, Ovesco, Germany). Antibiotic prophylaxis was prescribed, abdominal plain film was performed 5 hours after the procedure and hospital discharge was granted after twenty four hours. Results. The resection of the lesions was macroscopically complete and no signs of perforation or significant bleeding were detected. Histopathological examination confirmed the complete resection of a tubulovillous (n = 2) and a tubular (n = 1) adenoma, all with high-grade dysplasia. No complications were detected during the follow up. Conclusion. It was concluded that the EFTR is an innovative technique that was effective and safe used in this small series of patients as an alternative to surgery.

A novel grasp-and-loop closure method for defect closure after endoscopic full-thickness resection (with video)

2017 ◽  
Vol 31 (10) ◽  
pp. 4275-4282 ◽  
Author(s):  
Jian-wei Hu ◽  
Lei Ge ◽  
Ping-hong Zhou ◽  
Quan-lin Li ◽  
Yi-qun Zhang ◽  
...  
Keyword(s):  
Defect Closure ◽  
Full Thickness ◽  
Loop Closure ◽  
Endoscopic Full Thickness Resection ◽  
Closure Method

scholarly journals Early recurrence and the need for re-resection following Photodynamic diagnosis–assisted Transurethral Resection of Bladder Tumours: Multi-centre real-world experience of the UK PDD Users Group

2019 ◽  
pp. 205141581989046
Author(s):  
Paramananthan Mariappan ◽  
Colin Bunce ◽  
Jo Cresswell ◽  
Altaf Shamsuddin ◽  
Malcolm Crundwell ◽  
...  
Keyword(s):  
High Risk ◽  
Transurethral Resection ◽  
Residual Disease ◽  
Early Recurrence ◽  
Complete Resection ◽  
Photodynamic Diagnosis ◽  
High Grade ◽  
Risk Patients ◽  
Bladder Tumours

Objective: This study aimed to investigate the association between Photodynamic Diagnosis (PDD) with hexaminolevulinate (HAL) and the rate of complete resection and disease persistence at first follow-up cystoscopy for non-muscle-invasive bladder cancer (NMIBC) in UK real-world practice. Methods: Audit data were pooled from six UK centres where HAL PDD was used in patients with a new NMIBC diagnosis undergoing transurethral resection of bladder tumours (TURBT) since 2008. Patients received adjunctive intra-vesical therapy and surveillance in line with European and UK guidelines, including early re-resection in high-grade NMIBC. Results: PDD-assisted TURBT was done in 837 patients with new NMIBC. The detrusor muscle was present in 69.4% of cases. At early re-TURBT in 207 high-risk patients, 13.0% had residual disease. Multifocal disease was the most significant factor in increasing the rate of residual disease (odds ratio excluding cases of CIS=4.1; 95% confidence interval 1.5–11.3). The recurrence rate at first follow-up cystoscopy (RRFFC) was 10.6% (8.9% in patients with complete initial TURBT). In the historical cohort undergoing good-quality white-light TURBT, RRFFC was 31%; 40.5% of high-risk patients had residual disease at early re-TURBT. Conclusion: HAL PDD may increase the rates of complete resection, reducing the risk of early recurrence and the need for routine re-resection in high-grade NMIBC. Level of evidence: 2b.

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 Feasibility of Non-Exposure Simple Suturing Endoscopic Full-Thickness Resection in Comparison with Laparoscopic Endoscopic Cooperative Surgery for Gastric Subepithelial Tumors: Results of Two Independent Prospective Trials

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1858
Author(s):  
Bang Wool Eom ◽  
Chan Gyoo Kim ◽  
Myeong-Cherl Kook ◽  
Hong Man Yoon ◽  
Keun Won Ryu ◽  
...  
Keyword(s):  
Prospective Trial ◽  
Operating Time ◽  
Complete Resection ◽  
Full Thickness ◽  
Short Term ◽  
Endoscopic Full Thickness Resection ◽  
Prospective Trials ◽  
Gastric Subepithelial Tumors ◽  
Laparoscopic Endoscopic Cooperative Surgery ◽  
Subepithelial Tumors

Recently, nonexposure simple suturing endoscopic full-thickness resection (NESS-EFTR) method was developed to avoid tumor exposure to the peritoneal cavity. The aim of this study is to compare the short-term outcomes of the NESS-EFTR method with those of laparoscopic and endoscopic cooperative surgery (LECS) for gastric subepithelial tumors (SETs). A prospective single-center trial of LECS for gastric SETs was performed from March 2012 to October 2013 with a separate prospective trial of NESS-EFTR performed from August 2015 to June 2017, enrolling 15 patients each. Among the 30 enrolled patients, 14 who underwent LECS and 11 who underwent NESS-EFTR were finally included in the analysis. The rate of complete resection and successful closure was 100% in both groups. The operating time was longer for NESS-EFTR group than for LECS (110 vs. 189 min; p < 0.0001). There were no postoperative complications except one case of transient fever in the NESS-EFTR group. One patient in the LECS group had peritoneal seeding of gastrointestinal stromal tumor at 17 months postoperatively, and there was no other recurrence. Although NESS-EFTR had long operating and procedure times, it was feasible for patients with gastric SETs requiring a nonexposure technique.

scholarly journals Hybrid endoscopic mucosal resection and full-thickness resection for large colonic polyps harboring a small focus of invasive cancer: a case series

2021 ◽  
Vol 09 (11) ◽  
pp. E1686-E1691
Author(s):  
Jamie S. Chua ◽  
Hao Dang ◽  
Liselotte W. Zwager ◽  
Nik Dekkers ◽  
James C. H. Hardwick ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Case Series ◽  
Colonic Polyps ◽  
Full Thickness ◽  
Surveillance Colonoscopy ◽  
Noninvasive Treatment ◽  
Mucosal Resection ◽  
Endoscopic Full Thickness Resection ◽  
Small Focus

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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