Introduction Standard endoscopic resection of non-lifting adenomas and subepithelial tumours are challenging and pose significant risks of adverse events. Various methods for full thickness resection of these lesions have been trialled, but have been fraught with difficulties. Here we report a simple technique for colonic resections using a novel endoscopic full thickness resection (eFTR) device.
Methods Data on consecutive patients who underwent eFTR at 3 UK institutions from April 2014 – January 2015 were prospectively analysed. The procedure was undertaken using the, over-the-scope, full thickness resection device (FTRD). Main outcome measures were technical success, total procedure times, histological confirmation of full thickness, R0 resection and adverse events.
Results A total of 11 patients underwent eFTR, of which 5 were non-lifting adenomas, 4 T1 polyps and 2 subepithelial tumours. Procedure was technically successful in 82% (9/11) cases. The median age was 76 years (range 64–93 yrs), median procedure time was 40 minutes (range 22–60 mins) with a median specimen size of 22 mm (range 15–25 mm). Histology confirmed full thickness resection in all cases, with a R0 resection in 89% (8/9) cases. At 3 month endoscopic follow the anastomotic clip was still in situ in 3 cases. In 1 case (known R1 resection) a small 5 mm area of residual adenoma was noted which was successfully treated by conventional endoscopic means. There were no cases of immediate or delayed bleeding or perforation.
Conclusion eFTR using the FTRD system is a promising, simple technique to facilitate full thickness resections in the colon that may avoid the need for surgery in some selected cases. Further studies are now required to fully evaluate its efficacy.
Disclosure of Interest None Declared
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