Colorectal endoscopic full‐thickness resection: Initial experience from a tertiary centre in Singapore

Abstract

Background/Aims: Colorectal endoscopic full-thickness resection using the fullthickness resection device is an emerging endoscopic therapy for non-lifting adenomas and subepithelial lesions. We aim to describe our initial experience and examine the outcomes of colorectal endoscopic full-thickness resection in our centre.Methods: All colorectal endoscopic full-thickness resection performed from 2016 to 2021 were reviewed retrospectively. Demographic data, indication of endoscopic full-thickness resection, lesion size and location were collected. Outcomes assessed included technical success, complete resection, adverse events and need for surgery.Results: Thirteen patients were included in the study. Four patients had recurrent/ residual adenoma and nine had rectal neuroendocrine tumours (NETs). The resected specimens measured 20-mm. Mean lesion size was 9.77 mm. All but one lesions were located in rectum. Technical success and complete resection rates were 100%. One patient underwent right hemicolectomy for unsuspected T1 adenocarcinoma with deep submucosal invasion. Four patients had minor post-procedure bleeding. No major adverse events were identified.Conclusions: Colorectal endoscopic full-thickness resection with full-thickness resection device for treatment of residual/recurrent colorectal adenoma and rectal NET is efficacious and safe. It had a significant positive impact on management as it could definitively establish the adequacy of endoscopic resection by histology and confirm the feasibility of curative resection.

Device‐assisted endoscopic full‐thickness resection in colorectum: Systematic review and meta‐analysis

“…Twenty‐nine studies with 3467 patients (2045 [59%] male patients) and 3492 lesions were included in this systematic review and meta‐analysis 11–39 . The PRISMA flowchart of the study selection process is provided (Fig.…”

“…Subanalysis was done according to the type and size of lesions. In subepithelial lesions (12 studies), the pooled rate for histologically complete (R0) resection was 94.3% (95% CI 89.7–96.9%, I 2 0%) 14,17,18,20,24–30,33 . (Appendix S2).…”

“…In subepithelial lesions (12 studies), the pooled rate for histologically complete (R0) resection was 94.3% (95% CI 89.7-96.9%, I 2 0%). 14,17,18,20,[24][25][26][27][28][29][30]33 (Appendix S2).…”