Multicenter analysis of endoscopic full-thickness resection for gastrointestinal lesions in Poland

The full thickness resection is an innovative technique that enables non-exposed endoscopic full-thickness resection (EFTR) of superficial and subepithelial gastrointestinal lesions. This retrospective, multicenter study evaluated the effectiveness and safety of EFTR in gastroduodenal and colorectal resections.

Data from 105 consecutive EFTR procedures at 6 Polish endoscopic centers were analyzed. Patients were divided into three groups: 'difficult adenoma', adenocarcinoma, or subepithelial lesion (SEL). Outcomes assessed were R0 resection and adverse event rates, with subgroup analysis.

The study included 105 patients (mean age: 67 ± 10.3 years; 59% male): 48 (46%) with 'difficult adenoma', 31 (30%) with adenocarcinoma, and 26 (25%) with SEL. Of these, 82 patients (78%) underwent colorectal EFTR, while 23 (22%) underwent gastroduodenal EFTR. Technical success was achieved in 101 procedures (96%), with a median time of 30 (20; 40) minutes. Among the technically successful EFTRs, R0 resection was confirmed in 86 patients (97%): 18 (95%) in the SEL group, 45 (100%) in the 'difficult adenoma' group, and 23 (92%) in the adenocarcinoma group (p = 0.1806). In 13 EFTR procedures (13%), a scar from a previous endoscopic resection was removed without any pathological lesion. Curative resections were obtained in 21 (88%) patients in the SEL group and 20 (67%) patients in the adenocarcinoma group (p = 0.0001). Clinical adverse events occurred in 12 patients (11%): Clavien-Dindo grade I (5%), II (2%), and IIIb (5%).

EFTR is reasonably safe and effective for resection of colorectal and gastroduodenal lesions, which would otherwise most likely require surgical treatment.