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Endoscopic Full Thickness Resection With Endoscopic Suturing (EFTR-S) In 107 Rectal Lesions: A Single Center Experience On Safety And Efficacy & NBSP
Aims The aim of this study is to evaluate the efficacy and safety of EFTR with endoscopic suturing in rectal lesions.
Methods From June 2014 to November 2020, 107 EFTR procedures were performed in 104 patients. Defects were closed with full thickness endoscopic suturing technique with OverStitch. All resections were performed with flexible endoscopes only. Technical success and R0 resection rates were prospectively recorded and retrospectively analysed. 72 (67.2 %) of 107 resections were recurrent lesions after previous endoscopic or surgical treatment (1 TEM, 10 ESD, 2 DFTR, 3 EFTR-S, 56 EMR). Indications for treatment were 96 mucosal lesions (1 Anal canal squamous carcinoma, 2 hyperplasia, 75 adenomas 18 adenocarcinomas) and 11 sub mucosal lesions (5 NET, 5 GIST, 1 carcinoid).
Results Technical success of the procedure was 99 %, in only 1 of 107 lesions removal was not possible. Size of the lesion was 34.13 +/-4.75 (13-120) mm. The size of removed tissue was 54.10+/-14.94 (25-130) mm. Procedural time including suturing was 104.93 +/-27.18 (68-245) min. Histopathology confirmed R0 was achieved in 97 % of cases 103/106 of resections. 30-days complication rate was 4.71 %: 2 bleedings (1,88 %), 2 suture dehiscence in patients RCT neoadjuvant (1.88 %), 1 sigma stenosis (0.94 %). At 30 days no postoperative perforation was observed and none of mentioned complications required surgical intervention. Hospital stay was 1.89 +/- 0.89 (1-7) days. In 100 % of cases the tissue retrieved was adequate to formulate follow up therapy.
Conclusions EFTR with endoscopic suturing can be carried out safely and effectively. In our series we achieved 97 % histological R0 rate which is in our opinion a critical factor to choose the most appropriate therapeutic approach. Full thickness endoscopic suturing, providing a safe defects closure, expands the possibility to treat these patients with a minimally invasive approach with low complication rates and fast patient recovery.
Citation: Bisello M, Pregnolato P, Antoniello LM et al. OP221 ENDOSCOPIC FULL THICKNESS RESECTION WITH ENDOSCOPIC SUTURING (EFTR-S) IN 107 RECTAL LESIONS: A SINGLE CENTER EXPERIENCE ON SAFETY AND EFFICACY & NBSP. Endoscopy 2021; 53: S91.
Article published online:
19 March 2021
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