Endoscopy 2019; 51(04): S137
DOI: 10.1055/s-0039-1681573
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 13:00 – 13:30: Colon: resection 1 ePoster Podium 2
Georg Thieme Verlag KG Stuttgart · New York

SAFETY AND FEASIBILITY OF ENDOSCOPIC FULL-THICKNESS RESECTION IN COLORECTUM USING OVER THE SCOPE CLIP. A MULTICENTER SPANISH EXPERIENCE 2015 – 2018

, , Spanish Group of Endoscopic Resection (GSEED de Resección Mucosa)
H Uchima
1   Gastrointestinal Endoscopy, Hospital Universitario Doctor Josep Trueta de Girona, Girona, Spain
2   Gastrointestinal Endoscopy, Centro Medico Teknon, Barcelona, Spain
,
D Barquero
3   Hospital Sant Joan Despi-Moises Broggi, Barcelona, Spain
,
JM Esteban
4   Hospital Clinico San Carlos, Madrid, Spain
,
JC Espinos
2   Gastrointestinal Endoscopy, Centro Medico Teknon, Barcelona, Spain
5   Hospital Mutua Terrassa, Terrassa, Spain
,
JC Marín Gabriel
6   Gastroenterology, Hospital Universitario 12 de Octubre, Digestive System Service, Madrid, Spain
,
P Rosón
7   Hospital Quiron Salud Malaga, Málaga, Spain
,
F Fernandez Cadenas
8   Hospital Universitario Central de Asturias, Oviedo, Spain
,
A Ortega
7   Hospital Quiron Salud Malaga, Málaga, Spain
,
M López Fraile
8   Hospital Universitario Central de Asturias, Oviedo, Spain
,
L Mel
4   Hospital Clinico San Carlos, Madrid, Spain
,
MA Palacio Galán
8   Hospital Universitario Central de Asturias, Oviedo, Spain
,
I Puig
9   Althaia, Xarxa Assistencial Universitària de Manresa, Digestive System Service, Manresa, Spain
,
J Rodríguez-Sánchez
10   Gastrointestinal Endoscopy, Hospital General Universitario Ciudad Real, Ciudad Real, Spain
,
J Arribas
6   Gastroenterology, Hospital Universitario 12 de Octubre, Digestive System Service, Madrid, Spain
,
A Fernández Simón
3   Hospital Sant Joan Despi-Moises Broggi, Barcelona, Spain
,
F Sábado
11   Consorcio Hospitalario Provincial Castellón, Castellón, Spain
,
J García Lledó
12   Hospital Universitario Gregorio Marañón, Madrid, Spain
,
E Albéniz
13   Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit, Pamplona, Spain
,
A Mata
2   Gastrointestinal Endoscopy, Centro Medico Teknon, Barcelona, Spain
3   Hospital Sant Joan Despi-Moises Broggi, Barcelona, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

To study the safety and feasibility of the endoscopic full-thickness resection (EFTR) in colorectal lesions using an over-the-scope-clip.

Methods:

The clinical, endoscopic and histological data were collected prospectively in all cases of EFTR performed in 10 centers of Spain using the FTRD kit (Ovesco Endoscopy, Tübingen, Germany) during the period from June 2015 to July 2018.

Results:

71 EFTR were scheduled.

In 3 patients EFTR was not possible due to impossibility to pass the sigmoid with the kit.

In the other 68 patients the technical success was 85.2% with en-bloc resection in 83,8%.

The mean age of the patients was 67 years (range 40 – 86), being men 64,79%.

Indications were: non-lifting sign recurrent lesions (46.47%), non-lifting sign untreated lesions (23.94%), incomplete resection of non-lifting sign lesions (11,26%), appendicular lesions (2.8%), suspected T1 lesion (7%), EFTR of suspicious scar (4,2%), subepithelial lesions (4.2%).

The mean diameter of the resected specimen was 21.53 mm (95% CI 19.87 – 23,2).

Final histology: LGD adenoma (40%), HGD adenoma (23%), intramucosal adenocarcinoma (4.47%), SSP (5.87%), T1sm1 (2.9%), advanced adenocarcinoma >sm2 (13%), scar tissue (6%) and others (2.8%).

In one case the OTSC was not deployed, with intraprocedural perforation. There were 2 cases of delayed perforation and 1 case of delayed bleeding.

10 patients underwent surgery: 3 perforation, 1 intraapendicular lesion, and 6 for advanced adenocarcinoma.

During the follow-up, 3 recurrences/residual tissues were detected, which were treated endoscopically.

Conclusions:

EFTR using a modified OTSC (FTRD system) for selected cases (such as failure of other endoscopic treatments in lesions < 25 mm) is a safe and feasible technique.

Evaluation of the insertion with a long cap (e.g. "prOVE" cap) and traction of the lesion prior to EFTR is highly recommended. Special care must be taken to avoid performing the resection if the OTSC is not deployed.