Endoscopic full-thickness resection (EFTR) in the lower gastrointestinal tract

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Cancer Screening

Background:

• Endoscopic full-thickness resection (EFTR) offers an advanced endoscopic approach for colorectal lesions.
• It is particularly useful for lesions lacking a lifting sign, submucosal lesions, and mucosal carcinomas.

Purpose of the Study:

• To evaluate the efficacy and safety of EFTR using a specific device (FTRD).
• To assess resection completeness, technical success, and complications.
• To identify patient subgroups that benefit most from EFTR.

Main Methods:

• Retrospective multicenter study in Germany (November 2014 - December 2017).
• Utilized the FTRD System for EFTR in consecutive patients.
• Data collected from prospectively maintained institutional databases.

Main Results:

• 70 patients underwent colonoscopy for EFTR; 67 procedures were feasible.
• Technical success rate was 97.0% (65/67 patients).
• Histologically complete resection (R0) achieved in 90.8% (59/65). R0 rates were lower for lesions >20 mm (86.5%) vs. ≤20 mm (92.9%).
• Overall complication rate was 14.9% (1 major, others minor).

Conclusions:

• EFTR demonstrates excellent resection rates for specific colorectal lesions when performed by experienced endoscopists.
• The procedure can help avoid surgery in many cases.
• Lesion size impacts R0 resection rates, mandating careful patient selection.