ENDOSCOPIC FULL-THICKNESS RESECTION IN THE COLON – FIRST EXPERIENCE

Aims:

The purpose of the study was to evaluate feasibility, safety and efficiency of endoscopic full-thickness resection (FTR) in the colon.

Methods:

We prospectively evaluated all consecutive patients treated with FTR in our two centers (Vitkovice hospital, IKEM).

Results:

Twenty four patients (mean age 68.8 ± 12.3 years, 89% males) were treated between June 2016 and September 2017. Indication for resection was local residual neoplasia in 13 patients (54%), nonlifting neoplasia in 7 patients (29%), periappendicular neoplasia in 2 patients (8%), R1 resection of neuroendocrine neoplasia in 1 patient (4%) and transmural rectal biopsy to rule out Hirschprung disease in 1 patient (4%). The procedure was technically feasible in 23 patients (96%), in 1 patient we were unable to pull in a lesion fixed on the posterior rectal wall. Curative R0 resection was achieved in 20 out of 23 lesions (87%). In curatively treated patients, there were 5 sm 1 adenocarcinomas, 1 intramucosal cancer, 8 high-grade dysplasia adenomas, 4 low-grade dysplasia adenomas and 2 scars with no dysplasia. Complications occurred in 4 patients (17%), 3 patients suffered from delayed bleeding and 1 from acute appendicitis responding to conservative treatment.

Conclusions:

In our series, we show high technical feasibility of endoscopic full-thickness resection with a curative resection rate of 87%. Mild complications not requiring surgery occurred in 17% of patients.