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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(01): E19-E23
DOI: 10.1055/a-1967-2835
Original article

Endoscopic resection of upper gastrointestinal lesions using the colonic Ovesco full-thickness resection device: Retrospective observational case series of 22 cases

Jan-Erick Nilsson
1   University of Alberta, Edmonton, Alberta, Canada
,
Wilmar de Graaf
2   Erasmus MC, Rotterdam, South Holland, Netherlands
,
Arjun Dave Koch
2   Erasmus MC, Rotterdam, South Holland, Netherlands
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Comment on:

Endoscopy International Open – recently publishedEndoscopy 2023; 55(02): 202-202
DOI: 10.1055/a-1980-1446

Abstract

Background and study aims The endoscopic full-thickness resection (EFRT) device (FTRD) has been shown to have acceptable outcomes in regard to efficacy and safety in the resection of colorectal lesions. Data on its use in the upper gastrointestinal tract are limited to small case series.

Patients and methods All consecutive patients undergoing endoscopic full-thickness resection of gastric or duodenal lesions at our institutions were analyzed retrospectively for a primary endpoint of technical success.

Results A total of 22 patients with duodenal and gastric lesions underwent EFTR between June 2018 and February 2022. Technical success was achieved in 20 of 22 (91 %) of the procedures. Indications for EFTR were: subepithelial tumor (n = 14), mucosal lesion (n = 5), scar resection (n = 2), and EFTR of endoscopic submucosal dissection (ESD) resection base (n = 1). The FTRD could be advanced to the lesion in all 22 cases (100 %). No dilation of the upper esophageal sphincter (UES) or pylorus was required to pass the device. There were 14 cases of gastric lesions and eight duodenal. One subepithelial lesion was too big for the cap and one scar could not be sucked into the cap. One lesion (gastrointestinal stromal tumor) was removed at second procedure with the ESD technique, including over-the-scope clip. The R0 resection rate for deployed clips was 90 % (18 of 20). There were two superficial esophageal tears from FTRD insertion that required no therapy. No bleeding occurred during the postoperative period.

Conclusions Upper gastrointestinal EFTR using the colonic Ovesco FTRD is feasible without pre-dilation of the upper esophageal sphincter or pylorus. This study further confirms acceptable efficacy and safety in upper gastrointestinal use.



Publication History

Received: 29 April 2022

Accepted after revision: 19 October 2022

Accepted Manuscript online:
25 October 2022

Article published online:
04 January 2023

© 2022. 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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  • References

  • 1 Schmidt A, Bauerfeind P, Gubler C. et al. Endoscopic full-thickness resection in the colorectum with a novel over-the-scope device: First experience. Endoscopy 2015; 47: 719-725
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Richter-Schrag H-J, Walker C, Thimme R. et al. Full-thickness resection device (FTRD). Der Chir 2016; 87: 316-325
    CrossrefPubMedGoogle Scholar
  • 3 Schmidt A, Beyna T, Schumacher B. et al. Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications. Gut 2018; 67: 1280-1289
    CrossrefPubMedGoogle Scholar
  • 4 Fähndrich M, Sandmann M. Endoscopic full-thickness resection for gastrointestinal lesions using the over-the-scope clip system: a case series. Endoscopy 2014; 47: 76-79
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Schmidt A, Meier B, Cahyadi O. et al. Duodenal endoscopic full-thickness resection (with video). Gastrointest Endosc 2015; 82: 728-733
    CrossrefPubMedGoogle Scholar
  • 6 Bauder M, Schmidt A, Caca K. Endoscopic full-thickness resection of duodenal lesions—a retrospective analysis of 20 FTRD cases. United Eur Gastroenterol J 2018; 6: 1015-1021
    CrossrefPubMedGoogle Scholar
  • 7 Jung J, Choi K, Ahn J. et al. Endoscopic submucosal dissection for sessile, nonampullary duodenal adenomas. Endoscopy 2013; 45: 133-135
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Honda T, Yamamoto H, Osawa H. et al. Endoscopic submucosal dissection for superficial duodenal neoplasms. Dig Endosc 2009; 21: 270-274
    CrossrefPubMedGoogle Scholar
  • 9 Hoteya S, Yahagi N, Iizuka T. et al. Endoscopic submucosal dissection for nonampullary large superficial adenocarcinoma/adenoma of the duodenum: feasibility and long-term outcomes. Endosc Int Open 2014; 1: 2-7
    PubMedGoogle Scholar
  • 10 Kato M, Takeuchi Y, Hoteya S. et al. Outcomes of endoscopic resection for superficial duodenal tumors: 10 years’ experience in 18 Japanese high-volume centers. Endoscopy 2022; 54: 663-670
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Meier B, Schmidt A, Glaser N. et al. Endoscopic full-thickness resection of gastric subepithelial tumors with the gFTRD-system: a prospective pilot study (RESET trial). Surg Endosc 2020; 34: 853-860
    CrossrefPubMedGoogle Scholar
  • 12 von Renteln D, Kratt T, Rösch T. et al. Endoscopic full-thickness resection in the colon by using a clip-and-cut technique: an animal study. Gastrointest Endosc 2011; 74: 1108-1114
    CrossrefPubMedGoogle Scholar
  • 13 Schurr MO, Baur F, Ho CN. et al. Endoluminal full-thickness resection of GI lesions: A new device and technique. Minim Invasive Ther Allied Technol 2011; 20: 189-192
    CrossrefPubMedGoogle Scholar