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Ichkhanian Y , Vosoughi K , Diehl DL , Grimm IS , James TW , Templeton AW , Hajifathalian K , Tokar JL , Samarasena JB , Chehade NEH , Lee J , Chang K , Mizrahi M , Barawi M , Irani S , Friedland S , Korc P , Aadam AA , Al-Haddad MA , Kowalski TE , Novikov A , Smallfield G , Ginsberg GG , Oza VM , Panuu D , Fukami N , Pohl H , Lajin M , Kumta NA , Tang SJ , Naga YM , Amateau SK , Brewer GOI , Kumbhari V , Sharaiha R , Khashab MA
A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions
Surg Endosc. 2021 Mar 16;35(3) :1296-1306
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Abstract
BACKGROUND: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. METHODS: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). RESULTS: A total of 95 patients (mean age 65.5 +/- 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 +/- 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 +/- 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. CONCLUSIONS: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.
Notes
1432-2218 Ichkhanian, Y Vosoughi, K Diehl, D L Grimm, I S James, T W Templeton, A W Hajifathalian, K Tokar, J L Samarasena, J B Chehade, N El Hage Lee, J Chang, K Mizrahi, M Barawi, M Irani, S Friedland, S Korc, P Aadam, A A Al-Haddad, M A Kowalski, T E Novikov, A Smallfield, G Ginsberg, G G Oza, V M Panuu, D Fukami, N Pohl, H Lajin, Michael Kumta, N A Tang, S J Naga, Y M Amateau, S K Brewer, G O I Kumbhari, V Sharaiha, R Khashab, Mouen A Journal Article Germany Surg Endosc. 2020 Mar 16. pii: 10.1007/s00464-020-07504-9. doi: 10.1007/s00464-020-07504-9.