Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Oncology

Background:

• Endoscopic full-thickness resection (EFTR) is an emerging technique for colorectal lesions unsuitable for standard endoscopic removal.
• Assessing the efficacy and safety of EFTR devices is crucial for clinical adoption.

Purpose of the Study:

• To prospectively evaluate the efficacy and safety of a novel endoscopic full-thickness resection (EFTR) device.
• To determine the complete en bloc and R0 resection rates for various colorectal lesions.

Main Methods:

• A prospective, multicentre study involving 181 patients across 9 centres.
• Indications included difficult adenomas, early cancers, and subepithelial tumors (SET).
• Primary endpoints were complete en bloc and R0 resection rates, with adverse event monitoring and 3-month follow-up.

Main Results:

• EFTR achieved technical success in 89.5% and an overall R0 resection rate of 76.9%.
• For difficult adenomas, the R0 rate was 77.7%. For lesions ≤2 cm, the R0 rate was 81.2%, significantly higher than for larger lesions (58.1%).
• Adverse events occurred in 9.9% of cases, with a 2.2% rate of emergency surgery. Recurrent/residual tumor was observed in 15.3% at 3 months.

Conclusions:

• EFTR demonstrates reasonable technical efficacy and acceptable complication rates, particularly for colorectal lesions ≤2 cm.
• The curative resection rate for early cancers was insufficient for primary recommendation.
• Further comparative studies are needed to establish the long-term clinical value of EFTR for benign colorectal lesions.