Cargando…

Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece

BACKGROUND: Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD(®)) is an invasive treatment for colorectal lesions not resectable by conventional endoscopic techniques. This study presents the first Greek experience of the FTRD(®) procedure, assessing the effi...

Descripción completa

Detalles Bibliográficos
Autores principales: Velegraki, Magdalini, Trikola, Artemis, Vasiliadis, Konstantinos, Fragaki, Maria, Mpitouli, Afroditi, Dimas, Ioannis, Voudoukis, Evangelos, Giannikaki, Elpida, Kapranou, Amalia, Kordelas, Athanasios, Stefanidis, Gerasimos, Paspatis, Gregorios A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686092/
https://www.ncbi.nlm.nih.gov/pubmed/31474795
http://dx.doi.org/10.20524/aog.2019.0392
_version_ 1783442494678106112
author Velegraki, Magdalini
Trikola, Artemis
Vasiliadis, Konstantinos
Fragaki, Maria
Mpitouli, Afroditi
Dimas, Ioannis
Voudoukis, Evangelos
Giannikaki, Elpida
Kapranou, Amalia
Kordelas, Athanasios
Stefanidis, Gerasimos
Paspatis, Gregorios A.
author_facet Velegraki, Magdalini
Trikola, Artemis
Vasiliadis, Konstantinos
Fragaki, Maria
Mpitouli, Afroditi
Dimas, Ioannis
Voudoukis, Evangelos
Giannikaki, Elpida
Kapranou, Amalia
Kordelas, Athanasios
Stefanidis, Gerasimos
Paspatis, Gregorios A.
author_sort Velegraki, Magdalini
collection PubMed
description BACKGROUND: Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD(®)) is an invasive treatment for colorectal lesions not resectable by conventional endoscopic techniques. This study presents the first Greek experience of the FTRD(®) procedure, assessing the efficacy and safety of EFTR. METHODS: We conducted a retrospective analysis of 17 consecutive patients treated with the FTRD(®) at 2 referral centers from October 2015 through December 2018. The indications included difficult adenomas (non-lifting and/or at difficult locations), early adenocarcinomas and subepithelial tumors. Primary endpoints were technical success and R0 resection. RESULTS: Technical success and R0 resection were achieved in 82.3% procedures (14/17) and in 87.5% of those with difficult adenomas (8 patients). In the subgroup with carcinomas (n=3), the rate of technical success and R0 resection was 66.6%, while in the subgroup with subepithelial tumors (n=6) the rate was 83.3%. Technical success and R0 resection were significantly lower for lesions >20 mm vs. ≤20 mm (P=0.0429). In the 17 patients a total of 3 adverse events occurred (17.6%) and one of the patients underwent laparoscopic appendectomy because of EFTR around the appendix. CONCLUSIONS: Our study showed favorable results concerning EFTR feasibility, efficacy and safety, especially for lesions ≤20 mm, non-lifting adenomas, and subepithelial tumors. Technical success, R0 resection, and adverse events rates were comparable with previously published data. Larger randomized studies are needed to better define the clinical benefit and long-term outcomes of EFTR in selected patients.
format Online
Article
Text
id pubmed-6686092
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Hellenic Society of Gastroenterology
record_format MEDLINE/PubMed
spelling pubmed-66860922019-09-01 Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece Velegraki, Magdalini Trikola, Artemis Vasiliadis, Konstantinos Fragaki, Maria Mpitouli, Afroditi Dimas, Ioannis Voudoukis, Evangelos Giannikaki, Elpida Kapranou, Amalia Kordelas, Athanasios Stefanidis, Gerasimos Paspatis, Gregorios A. Ann Gastroenterol Original Article BACKGROUND: Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD(®)) is an invasive treatment for colorectal lesions not resectable by conventional endoscopic techniques. This study presents the first Greek experience of the FTRD(®) procedure, assessing the efficacy and safety of EFTR. METHODS: We conducted a retrospective analysis of 17 consecutive patients treated with the FTRD(®) at 2 referral centers from October 2015 through December 2018. The indications included difficult adenomas (non-lifting and/or at difficult locations), early adenocarcinomas and subepithelial tumors. Primary endpoints were technical success and R0 resection. RESULTS: Technical success and R0 resection were achieved in 82.3% procedures (14/17) and in 87.5% of those with difficult adenomas (8 patients). In the subgroup with carcinomas (n=3), the rate of technical success and R0 resection was 66.6%, while in the subgroup with subepithelial tumors (n=6) the rate was 83.3%. Technical success and R0 resection were significantly lower for lesions >20 mm vs. ≤20 mm (P=0.0429). In the 17 patients a total of 3 adverse events occurred (17.6%) and one of the patients underwent laparoscopic appendectomy because of EFTR around the appendix. CONCLUSIONS: Our study showed favorable results concerning EFTR feasibility, efficacy and safety, especially for lesions ≤20 mm, non-lifting adenomas, and subepithelial tumors. Technical success, R0 resection, and adverse events rates were comparable with previously published data. Larger randomized studies are needed to better define the clinical benefit and long-term outcomes of EFTR in selected patients. Hellenic Society of Gastroenterology 2019 2019-06-10 /pmc/articles/PMC6686092/ /pubmed/31474795 http://dx.doi.org/10.20524/aog.2019.0392 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Velegraki, Magdalini
Trikola, Artemis
Vasiliadis, Konstantinos
Fragaki, Maria
Mpitouli, Afroditi
Dimas, Ioannis
Voudoukis, Evangelos
Giannikaki, Elpida
Kapranou, Amalia
Kordelas, Athanasios
Stefanidis, Gerasimos
Paspatis, Gregorios A.
Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece
title Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece
title_full Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece
title_fullStr Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece
title_full_unstemmed Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece
title_short Endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in Greece
title_sort endoscopic full-thickness resection of colorectal lesions with the full-thickness resection device: clinical experience from two referral centers in greece
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686092/
https://www.ncbi.nlm.nih.gov/pubmed/31474795
http://dx.doi.org/10.20524/aog.2019.0392
work_keys_str_mv AT velegrakimagdalini endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT trikolaartemis endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT vasiliadiskonstantinos endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT fragakimaria endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT mpitouliafroditi endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT dimasioannis endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT voudoukisevangelos endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT giannikakielpida endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT kapranouamalia endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT kordelasathanasios endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT stefanidisgerasimos endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece
AT paspatisgregoriosa endoscopicfullthicknessresectionofcolorectallesionswiththefullthicknessresectiondeviceclinicalexperiencefromtworeferralcentersingreece