Clin Endosc.  2018 Jan;51(1):103-108. 10.5946/ce.2017.093.

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

Affiliations
  • 1Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Göttingen, Göttingen, Germany. edris.wedi@med.uni-goettingen.de
  • 2Department of Gastroenterology, Careggi University Hospital, Florence, Italy.
  • 3Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, IN, USA.
  • 4Department of Pathology, Nouvel Hôpital Civil, Strasbourg University Hospitals, Strasbourg, France.
  • 5Department of Internal Medicine, Vivantes Klinikum im Friedrichshain, University Teaching Hospital of Humboldt University Berlin (Charité), Berlin, Germany.

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.

Keyword

Colonoscopy; Colorectal neoplasms; Full-thickness resection device; Over-the-scope-clip
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