1. Colo-rectal endoscopic full-thickness resection (EFTR) with the over-the-scope device (FTRD®): A multicenter Italian experience
- Author
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Margherita Pizzicannella, Lucio Petruzziello, Gianluca Andrisani, Stefania Ghersi, Paolo Cecinato, Franco Coppola, Federico Iacopini, Paola Soriani, G. De Nucci, Pavlos Lagoussis, A. La Terra, Guido Costamagna, Sara Vavassori, Mauro Manno, F.M. Di Matteo, R. Salerno, Monica Pandolfi, Cristina Grossi, M. Mutignani, Riccardo Naspetti, and Francesco Pugliese
- Subjects
medicine.medical_specialty ,Hepatology ,Adenoma ,business.industry ,Gastroenterology ,Histology ,medicine.disease ,digestive system diseases ,Appendix ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Dysplasia ,030220 oncology & carcinogenesis ,Carcinoma ,Medicine ,030211 gastroenterology & hepatology ,Radiology ,Full thickness resection ,medicine.symptom ,business ,Prospective cohort study - Abstract
Background and aim Endoscopic full-thickness resection(EFTR) with FTRD® in colo-rectum may be useful for several indications.The aim was to assess its efficacy and safety. Material and methods In this retrospective multicenter study 114 patients were screened; 110 (61M/49F, mean age 68 ± 11 years, range 20–90) underwent EFTR using FTRD®. Indications were:residual/recurrent adenoma (39), incomplete resection at histology (R1 resection) (26), non-lifting lesion (12), adenoma involving the appendix (2) or diverticulum (2), subepithelial lesions(10), suspected T1 carcinoma (16), diagnostic resection (3). Technical success (TS: lesion reached and resected), R0 resection (negative lateral and deep margins),EFTR rate(all layers documented in the specimen) and safety have been evaluated. Results TS was achieved in 94.4% of cases. EFTR was achieved in 91% with lateral and deep R0 resection in 90% and 92%. Mean size of specimens was 20 mm (range 6–42). In residual/recurrent adenomas, final analysis revealed: low-risk T1 (11), adenoma with low-grade dysplasia (LGD) (24) and high-grade dysplasia (HGD) (3), scar tissue (1). Histology reports of R1 resections were: adenoma with LGD (6), with HGD (1), low-risk (6) and high-risk (1) T1, scar tissue (12). Non-lifting lesions were diagnosed as: adenoma with HGD (3), low-risk (7) and high risk (2) T1. Adverse clinical events occurred in 12 patients (11%),while adverse technical events in11%. Three-months follow-up was available in 100 cases and residual disease was evident in only seven patients. Conclusions EFTR using FTRD® seems to be a feasible, effective and safe technique for treating selected colo-rectal lesions. Comparative prospective studies are needed to confirm these promising results.
- Published
- 2019
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