473 Endoscopic Full-Thickness Resection in Colorectal Cancer

Küllmer, Armin; Müeller, Jens-Dominik; Caca, Karel; Aepli, Patrick; Dakkak, Dani; Schumacher, Brigitte; Glitsch, Anne; Schäfer, Claus; Wallstabe, I.; Hofmann, Christopher; Erhardt, Andreas; Meier, Benjamin; Bettinger, Dominik; Thimme, Robert; Schmidt, Arthur

doi:10.1016/j.gie.2019.04.066

Cited by 1 publication

(2 citation statements)

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“…Surgical resection was necessary in the other cases due to a high-risk situation 30 . Given these limitations, easier use of FTRD, results from this meta-analysis, and data by Küllmer et al 31 on colonic EFTR for polyps with malignant histology, full-thickness resection with FTRD would be the primary choice for difficult adenomas. The role of a hybrid-technique combining EFTR and EMR for lager lesions seems promising 32 33 but yet needs to be further evaluated.…”

Section: Discussionmentioning

confidence: 92%

“…With regard to difficult adenomas, R0 resection rate was 77.7 %, and a residual lesion was found in 15.3 % in the prospective study by Schmidt et al 9 Outcome in the subgroup of patients with malignant histology was recently reported by Küllmer at al. 31 . That study included 156 patients, of whom 64 underwent repeat resection of a malignant polyp and 92 who underwent EFTR for a non-lifting lesion with subsequently malignant histology.…”

Section: Discussionmentioning

confidence: 99%

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

2021

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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.

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