Endoscopy 2018; 50(04): S80
DOI: 10.1055/s-0038-1637265
ESGE Days 2018 oral presentations
21.04.2018 – Colon: endoscopic resection session 2
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC FULL-THICKNESS RESECTION (EFTR) USING FTRD SYSTEM FOR COLONIC LESIONS. EVALUATION OF THE TECHNICAL DIFFICULTIES

H Uchima
1   Hospital Universitari de Girona Dr. Josep Trueta, Gastrointestinal Endoscopy Unit, Girona, Spain
,
D Barquero
2   Hospital Sant Joan Despí-Moises Broggi, Gastrointestinal Endoscopy Unit, Barcelona, Spain
,
A Fernandez
2   Hospital Sant Joan Despí-Moises Broggi, Gastrointestinal Endoscopy Unit, Barcelona, Spain
,
C Huertas
1   Hospital Universitari de Girona Dr. Josep Trueta, Gastrointestinal Endoscopy Unit, Girona, Spain
,
X Andujar
3   Hospital Mutua Terrassa, Gastrointestinal Endoscopy Unit, Barcelona, Spain
,
M Figa
1   Hospital Universitari de Girona Dr. Josep Trueta, Gastrointestinal Endoscopy Unit, Girona, Spain
,
C Loras
3   Hospital Mutua Terrassa, Gastrointestinal Endoscopy Unit, Barcelona, Spain
,
J Espinos
3   Hospital Mutua Terrassa, Gastrointestinal Endoscopy Unit, Barcelona, Spain
,
A Mata
2   Hospital Sant Joan Despí-Moises Broggi, Gastrointestinal Endoscopy Unit, Barcelona, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available at
 

Aims:

To evaluate the technical difficulties associated with the procedure.

To study the safety and feasibility of EFTR for colonic lesions.

Methods:

Clinical, endoscopic, anatomopathological and technique evaluation data of all cases of EFTR performed in 3 centers in Catalonia using the FTRD system set (Ovesco Endoscopy, Tübingen, Germany) were collected prospectively during the period between June 2015 and October 2017.

During each procedure the endoscopist assessed whether each step was difficult or not.

Results:

24 EFTR of the colon were performed. The mean age was 67 years (53 – 79), with men being 70%.

The indications were recurrent/residual lesions with non lifting sign (75%) and untreated lesions with non lifting sign (25%). The locations were right colon (n = 8; 34%), transverse colon (n = 5; 21%), left colon (n = 8; 34%), rectosigmoid junction (1; 4%) and anastomosis (n = 2; 8%). The mean diameter of the resected samples was 21 mm (11 – 35 mm). The histology of the lesions was adenocarcinoma with deep submucosal invasion (> 1000um) in 5 cases (22%).

There was one case of perforation 72 hours after the procedure that required emergency surgery.

Regarding the technique, the table summarizes the number of times each step was considered difficult by the endoscopist.

Tab. 1:

Steps evaluation

Steps

Number of times considered difficult n (%)

Number of times with negative impact on overall technical success n (%)

Face the lesion

5 (21%)

2 (40%)

Insertion of the scope with FTRD system

15 (62.5%)

3 (20%)

Pull the lesion into the cap

12 (50%)

4 (33%)

Snare and resect

5 (21%)

3 (60%)

Insertion was hard specially in those cases with diverticulosis.

OTSC deployment was not considered difficult, but it is important to mention that there is poor feedback when using the release wheel.

Conclusions:

EFTR is a feasible technique for selected cases in colon.

More studies may be needed to evaluate safety.

Evaluation of the traction of the lesion prior to EFTR is recommended.