Technical failure during colorectal endoscopic full-thickness resection: the "through thick and thin" study

被引：3

作者：

Gibiino, Giulia ^{[1
]}

Binda, Cecilia ^{[1
]}

Papparella, Luigi Giovanni ^{[3
]}

Spada, Cristiano ^{[3
]}

Andrisani, Gianluca

Di Matteo, Francesco Maria ^{[4
]}

Gagliardi, Mario ^{[5
]}

Maurano, Attilio ^{[5
]}

Sferrazza, Sandro ^{[6
]}

Azzolini, Francesco ^{[7
]}

Grande, Giuseppe ^{[8
]}

de Nucci, Germana ^{[9
]}

Cesaro, Paola ^{[10
]}

Aragona, Giovanni ^{[11
]}

Cennamo, Vincenzo

Fusaroli, Pietro ^{[13
]}

Staiano, Teresa ^{[14
]}

Soriani, Paola

Campanale, Mariachiara ^{[16
]}

Di Mitri, Roberto ^{[6
]}

Pugliese, Francesco ^{[17
]}

Anderloni, Andrea ^{[18
]}

Cucchetti, Alessandro

Repici, Alessandro ^{[19
,20
]}

Fabbri, Carlo ^{[1
,2
]}

Sbrancia, Monica ^{[1
]}

Coluccio, Chiara ^{[1
]}

Frazzoni, Leonardo ^{[1
]}

Barbaro, Federico

Petruzziello, Lucio

Vieceli, Filippo ^{[21
]}

Mandarino, Francesco Vito ^{[7
]}

Cocca, Silvia ^{[8
]}

Ghersi, Stefania ^{[12
]}

Manno, Mauro ^{[15
]}

Amata, Michele ^{[6
]}

Dioscoridi, Lorenzo

Mutignani, Massimiliano

机构：

[1] Morgagni Pierantoni Hosp, Gastroenterol & Digest Endoscopy Units, Via Carlo Forlanini 34, I-47121 Forli, Italy

[2] Maurizio Bufalini Hosp, Cesena, Italy

[3] Policlin Agostino Gemelli Univ, Ctr Endoscop Res Therapeut & Training CERTT, Rome, Italy

[4] Univ Campus Biomed, Digest Endoscopy Unit, Rome, Italy

[5] Osped Gaetano Fucito, Digest Endoscopy Unit, Mercato San Severino, Italy

[6] ARNAS Civ Hosp, Gastroenterol & Digest Endoscopy Unit, Palermo, Italy

[7] Univ Vita Salute San Raffaele, Gastroenterol & Gastrointestinal Endocopy, Milan, Italy

[8] Univ Modena, Azienda Osped, Gastroenterol & Digest Endoscopy Unit, Modena, Italy

[9] Garbagnate Milanese Hosp, Gastroenterol & Endoscopy Unit, Milan, Italy

[10] Fdn Poliambulanza Ist Osped, Digest Endoscopy Unit, Brescia, Italy

[11] Osped Guglielmo Saliceto, Gastroenterol & Hepatol Unit, Piacenza, Italy

[12] Azienda USL Bologna, Gastroenterol & Digest Endoscopy Unit, Bologna, Italy

[13] Univ Bologna, Dept Med & Surg Sci DIMEC, Bologna, Italy

[14] FPO IRCCS, Candiolo Canc Inst, Candiolo, Italy

[15] Azienda USL Modena, Gastroenterol & Digest Endoscopy Unit, Carpi, Italy

[16] Galliera Hosp, Digest Endoscopy Unit, Genoa, Italy

[17] Osped Niguarda Ca Granda, ASST Niguarda, Digest Endoscopy Unit, Milan, Italy

[18] Fdn IRCCS Policlin San Matteo, Dept Endoscopy, Pavia, Italy

[19] Humanitas Univ, Dept Biomed Sci, Pieve Emanuele, Italy

[20] Humanitas Clin & Res Ctr IRCCS, Endoscopy Unit, Rozzano, Italy

[21] St Chiara Hosp, APSS Trento, Gastroenterol & Digest Endoscopy Unit, Trento, Italy

来源：

ENDOSCOPY | 2024年 / 56卷 / 11期

关键词：

MUCOSAL RESECTION; ADVERSE EVENTS; GERMAN; SNARE;

D O I：

10.1055/a-2328-4753

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Endoscopic full-thickness resection (EFTR) is an effective and safe technique for non lifting colorectallesions. Technical issues or failures with the full-thickness resection device (FTRD) system are reported, but there are no detailed data. The aim of our study was to quantify and classify FTRD technical failures. Methods We performed a retrospective study involving 17Italian centers with experience in advanced resection techniques and the required devices. Each center shared and classified all prospectively collected consecutive failures during colorectal EFTR using the FTRD from 2018 to 2022.The primary outcome was the technical failure rate and their classification; secondary outcomes included subsequent management, clinical success, and complications. Results Included lesions were mainly recurrent (52%), with a mean (SD) dimension of 18.4 (7.5) mm. Among 750EFTRs, failures occurred in 77 patients (35 women; mean[SD] age 69.4 [8.9] years). A classification was proposed: type I, snare noncutting (53%); type II, clip misdeployment (31%); and type III, cap misplacement (16%). Among endo-scopic treatments completed, rescue endoscopic mucosal resection was performed in 57 patients (74%), allowing enbloc and R0 resection in 71% and 64%, respectively. The overall adverse event rate was 27.3%. Pooled estimates for the rates of failure, complications, and rescue endoscopic therapy were similar for low and high volume centers (P=0.08,P=0.70, and P=0.71, respectively). Conclusions Colorectal EFTR with the FTRD is a challenging technique with a non-negligible rate of technical failure and complications. Experience in rescue resection techniques and multidisciplinary management are mandatory in this setting.

引用

页码：831 / 839

页数：9

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