Treatment of neoplastic colonic lesions using the full-thickness resection device

BACKGROUND AND AIMS: Advanced adenomas and scarred lesions pose difficulties for the endoscopist because of the need for complete resection and accurate pathologic staging, which cannot be afforded by standard resection techniques. Endoscopic full-thickness resection, first described in Europe for treatment of early adenocarcinoma or scarred lesions in the colon, allows potentially curative en bloc resection in patients who may be at a high risk for surgery. We describe our endoscopic approach and histologic outcomes with use of a commercially available endoscopic full-thickness resection device (FTRD) (Ovesco Endoscopy, Tubingen, Germany). METHODS: We report our experience using the FTRD for advanced polyps in patients referred to our tertiary care center. Three patients were identified from a prospectively maintained database of patients undergoing FTRD from December 2018 to February 2019. Demographic, endoscopic, and histologic data were collected. RESULTS: All patients underwent successful full-thickness resection of the adenocarcinoma, and histopathologic examination showed negative lateral and deep margins. No immediate or delayed adverse events occurred during an average 2-month follow-up period. CONCLUSIONS: Full-thickness resection with an over-the-scope fitted FTRD is safe and effective in the management of advanced colonic neoplastic lesions.