Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Full-Thickness Resection Device for Complex Colorectal Lesions in High-Risk Patients as a Last-Resort Endoscopic Treatment: Initial Clinical Experience and Review of the Current Literature

  • Wedi, Edris (Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Gottingen) ;
  • Orlandini, Beatrice (Department of Gastroenterology, Careggi University Hospital) ;
  • Gromski, Mark (Division of Gastroenterology, Indiana University School of Medicine) ;
  • Jung, Carlo Felix Maria (Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Gottingen) ;
  • Tchoumak, Irina (Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Gottingen) ;
  • Boucher, Stephanie (Department of Pathology, Nouvel H?pital Civil, Strasbourg University Hospitals) ;
  • Ellenrieder, Volker (Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Gottingen) ;
  • Hochberger, Jurgen (Department of Internal Medicine, Vivantes Klinikum im Friedrichshain, University Teaching Hospital of Humboldt University Berlin (Charite))
  • Received : 2017.06.07
  • Accepted : 2017.10.20
  • Published : 2018.01.30
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Abstract

The full-thickness resection device (FTRD) is a novel endoscopic device approved for the resection of colorectal lesions. This case-series describes the device and its use in high-risk patients with colorectal lesions and provides an overview of the potential indications in recently published data. Between December 2014 and September 2015, 3 patients underwent endoscopic full thickness resection using the FTRD for colorectal lesions: 1 case for a T1 adenocarcinoma in the region of a surgical anastomosis after recto-sigmoidectomy, 1 case for a non-lifting colonic adenoma with low-grade dysplasia in an 89-year old patient and 1 for a recurrent adenoma with high-grade dysplasia in a young patient with ulcerative rectocolitis who was under immunosuppression after renal transplantation. Both technical and clinical success rates were achieved in all cases. The size of removed lesions ranged from 9 to 30 mm. Overall, the most frequent indication in the literature has been for lifting or non-lifting adenoma, submucosal tumors, neuroendocrin tumors, incomplete endoscopic resection (R1) or T1 carcinoma. Colorectal FTRD is a feasible technique for the treatment of colorectal lesions and represents a minimally invasive alternative for either surgical or conventional endoscopic resection strategies.

Keywords

References

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