Outcomes of a hybrid technique using EMR and endoscopic full-thickness resection for polyps not amenable to standard techniques (with video)

Outcomes of a hybrid technique using EMR and endoscopic full-thickness resection for polyps not amenable to standard techniques (with video)

The full-thickness resection device (FTRD) offers a safe and effective approach for resection of complex colorectal lesions but is limited to lesions 

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Veröffentlicht in:Gastrointestinal endoscopy 2021-08, Vol.94 (2), p.358-367.e1
Hauptverfasser: Mahadev, SriHari, Vareedayah, Ashley A., Yuen, Sofia, Yuen, William, Koller, Kristen A., Haber, Gregory B.
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container_end_page 367.e1
container_issue 2
container_start_page 358
container_title Gastrointestinal endoscopy
container_volume 94
creator Mahadev, SriHari
Vareedayah, Ashley A.
Yuen, Sofia
Yuen, William
Koller, Kristen A.
Haber, Gregory B.
description The full-thickness resection device (FTRD) offers a safe and effective approach for resection of complex colorectal lesions but is limited to lesions 
doi_str_mv 10.1016/j.gie.2021.02.009
format Article
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A hybrid approach—combining EMR with the FTRD—significantly expands the pool of lesions amenable to this technique; however, its safety and efficacy has not been well established. We report a single-center retrospective study of consecutive patients who underwent full-thickness resection (FTR) of colorectal lesions, either with a standalone FTRD or a hybrid (EMR + FTRD) approach. Outcomes of technical success, clinical success (macroscopically complete resection), R0 resection, and adverse events (AEs) were evaluated. Sixty-nine FTR procedures (38 standalone FTR and 31 hybrid EMR + FTR) were performed on 65 patients. The most common indications were nonlifting polyp (43%) or suspected high-grade dysplasia or carcinoma (38%). Hybrid EMR + FTR permitted resection of significantly larger lesions (mean, 39 mm; range, 15-70 mm) compared with standalone FTR (mean, 17 mm; range, 7-25 mm; P &lt; .01). Clinical success (91%), technical success (83%), and R0 resection (81%) rates did not differ between standalone and hybrid groups. Most patients (96%) were discharged home on the day of the procedure. Three AEs occurred, including 2 patients who developed acute appendicitis. A hybrid approach combining EMR and FTRD maintains safety and efficacy while permitting resection of significantly larger lesions than FTRD alone. 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title Outcomes of a hybrid technique using EMR and endoscopic full-thickness resection for polyps not amenable to standard techniques (with video)
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