CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(11): E1686-E1691
DOI: 10.1055/a-1529-1447
Innovation forum

Hybrid endoscopic mucosal resection and full-thickness resection for large colonic polyps harboring a small focus of invasive cancer: a case series

Jamie S. Chua
1   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
,
Hao Dang
1   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
,
Liselotte W. Zwager
2   Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, the Netherlands
,
Nik Dekkers
1   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
,
James C. H. Hardwick
1   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
,
Alexandra M. J. Langers
1   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
,
Jolein van der Kraan
1   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
,
Lars E. Perk
3   Department of Gastroenterology and Hepatology, Haaglanden Medical Center, the Hague, the Netherlands
,
Barbara A. J. Bastiaansen
2   Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, the Netherlands
,
Jurjen J. Boonstra
1   Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
,
on behalf of the Dutch eFTR Working Group › Author Affiliations

Abstract

Endoscopic treatment of large laterally spreading tumors (LSTs) with a focus of submucosally invasive colorectal cancer (T1 CRC) can be challenging. We evaluated outcomes of a hybrid resection technique using piecemeal endoscopic mucosal resection (pEMR) and endoscopic full-thickness resection (eFTR) in patients with large colonic LSTs containing suspected T1 CRC. Six hybrid pEMR-eFTR procedures for T1 CRCs were registered in a nationwide eFTR registry between July 2015 and December 2019. In all cases, the invasive part of the lesion was successfully isolated with eFTR; with eFTR, histologically complete resection of the invasive part was achieved in 5 /6 patients (83.3 %). No adverse events occurred during or after the procedure. The median follow-up time was 10 months (range 6–27), with all patients having undergone ≥ 1 surveillance colonoscopy. One patient had a small adenomatous recurrence, which was removed endoscopically. In conclusion, hybrid pEMR-eFTR is a promising noninvasive treatment modality that seems feasible for a selected group of patients with large LSTs containing a small focus of T1 CRC.



Publication History

Received: 13 March 2021

Accepted: 08 June 2021

Article published online:
12 November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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