Colo-rectal endoscopic full-thickness resection (EFTR) with the over-the-scope device (FTR®): A multicenter Italian experience

被引：51

作者：

Andrisani, G. ^{[1
]}

Soriani, P. ^{[2
]}

Manno, M. ^{[2
]}

Pizzicannella, M. ^{[1
]}

Pugliese, F. ^{[3
]}

Mutignani, M. ^{[3
]}

Naspetti, R. ^{[4
]}

Petruzziello, L. ^{[5
]}

Iacopini, F. ^{[6
]}

Grossi, C. ^{[6
]}

Lagoussis, P. ^{[7
]}

Vavassori, S. ^{[7
]}

Coppola, F. ^{[8
]}

La Terra, A. ^{[8
]}

Ghersi, S. ^{[9
]}

Cecinato, P. ^{[10
]}

De Nucci, G. ^{[11
]}

Salerno, R. ^{[12
]}

Pandolfi, M. ^{[1
]}

Costamagna, G. ^{[5
]}

Di Matteo, F. M. ^{[1
]}

机构：

[1] Campus Biomed, Digest Endoscopy Unit, Rome, Italy

[2] Ramazzini Hosp, Digest Endoscopy Unit, Modena, Italy

[3] Osped Niguarda Ca Granda, Diagnost & Intervent Digest Endoscopy, Milan, Italy

[4] Careggi Hosp, Surg Endoscopy Unit, Florence, Italy

[5] Gemelli Univ Hosp, Digest Endoscopy Unit, Rome, Italy

[6] S Giuseppe Hosp, Gastroenterol Endoscopy Unit, Rome, Italy

[7] IRCCS Policlin San Donato, Div Gen Surg 1, San Donato Milanese, Italy

[8] San Giovanni Bosco Hosp, Dept Gastroenterol, Turin, Italy

[9] AUSL Bologna, Gastroenterol & Digest Endoscopy Unit, Bologna, Italy

[10] Arcispedale Santa Maria Nuova, Unit Gastroenterol & Digest Endoscopy, Reggio Emilia, Italy

[11] AO Salvini, Gastroenterol & Digest Endoscopy Unit, Garbagnate Milanese, Italy

[12] ASST Fatebenefratelli Sacco, Endoscopy Unit, Milan, Italy

来源：

DIGESTIVE AND LIVER DISEASE | 2019年 / 51卷 / 03期

关键词：

Adenoma relapse; Colo-rectal cancer; Full thickness resection; No lift lesion; Scar of previous endoscopic resection; SUBMUCOSAL DISSECTION; RISK-FACTORS; CLINICAL-OUTCOMES; RADICAL RESECTION; MUCOSAL NEOPLASIA; CLIP SYSTEM; LESIONS; MANAGEMENT; TUMORS; RECURRENT;

D O I：

10.1016/j.dld.2018.09.030

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and aim: Endoscopic full-thickness resection(EFTR) with FTR (R) in colo-rectum may be useful for several indications.The aim was to assess its efficacy and safety. Material and methods: In this retrospective multicenter study 114 patients were screened; 110 (61M/49F, mean age 68 +/- 11 years, range 20-90) underwent EFTR using FTR (R). Indications were:residual/recurrent adenoma (39), incomplete resection at histology (R1 resection) (26), non-lifting lesion (12), adenoma involving the appendix (2) or diverticulum (2), subepithelial lesions( 10), suspected T1 carcinoma (16), diagnostic resection (3). Technical success (TS: lesion reached and resected), RO resection (negative lateral and deep margins),EFTR rate(all layers documented in the specimen) and safety have been evaluated. Results: TS was achieved in 94.4% of cases. EFTR was achieved in 91% with lateral and deep RO resection in 90% and 92%. Mean size of specimens was 20 mm (range 6-42). In residual/recurrent adenomas, final analysis revealed: low-risk T1 (11), adenoma with low-grade dysplasia (LGD) (24) and high-grade dysplasia (HGD) (3), scar tissue (1). Histology reports of R1 resections were: adenoma with LGD (6), with HGD (1), low-risk (6) and high-risk (1) T1, scar tissue (12). Non-lifting lesions were diagnosed as: adenoma with HGD (3), low-risk (7) and high risk (2) Tl. Adverse clinical events occurred in 12 patients (11%),while adverse technical events in11%. Three-months follow-up was available in 100 cases and residual disease was evident in only seven patients. Conclusions: EFTR using FTR (R) seems to be a feasible, effective and safe technique for treating selected colo-rectal lesions. Comparative prospective studies are needed to confirm these promising results. (C) 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

引用

页码：375 / 381

页数：7

共 36 条

[1] Endoscopic full thickness resection (EFTR) of colorectal neoplasms with the Full Thickness Resection Device (FTRD): Clinical experience from two tertiary referral centers in Switzerland [J].