OUR EXPERIENCE IN EFTR OF COLORECTAL LESIONS USING THE FTRD

Aims Full-thickness resection device (FTRD) is an over-the-scope system (Ovesco) which allows a single-step endoscopic full-thickness resection (EFTR). It is an emerging technique for the treatment of naive, residual or relapsing lesions, smaller than 25 mm. The aims of our study are to describe colorectal lesions resected by FTRD and evaluate its efficacy and safety.

Methods A descriptive retrospective study of first 5 consecutive patients treated by FTRD at University Hospital of Burgos from august-2018 to may-2019.

Results 5 procedures in 5 patients, all colonoscopies with deep sedation by endoscopists. Mean age 66.4 ± 7.5 years, 60% male. Indication of FTRD was adenoma recurrence in 3 patients (with high grade dysplasia from naive lesions of 40, 20 and 9 mm) and incomplete polypectomy in 2 patients (intramucosal adenocarcinoma from serrated polyp of 15 mm and adenoma with low grade dysplasia of 10 mm). 2 lesions were located in the right colon, 1 in transverse, 1 in left and 1 in rectum. Technical success was achieved in 100%. Mean size of the resected fragment was 23 ± 5.7 mm, all of them were R0 (radical resection). EFTR-specimens showed residual lesion in 3 patients, mean size of 6.3 mm; 2 patients without residual lesion. First colonoscopy review (3 months): 4 patients without adenoma, a patient is still waiting. Mean follow-up of 214 ± 62 days. All patients received antibiotic prophylaxis (amoxicillin-clavulanic). Mean hospital stay was 4 days. Early complications (< 7days): 1 bleeding after releasing the Ovesco solved with hemoclip and 1 postpolypectomy syndrom with subocclusive syndrome resolved in 48 hours. No major complications were detected.

Conclusions FTRD is an effective technique for the resection of colorectal lesions with a low complication rate that is why it could be an alternative to surgery management in selected cases even in hospital without previous experience.