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Multistaged endoscopic full-thickness resection using full-thickness resection device for large recurrent polyp: a

Taylor Bowler1, Natalie Wilson1, Rahul Karna2

  • 1Department of Internal Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota, USA.

Igie : Innovation, Investigation and Insights
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Multistaged endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD) safely and effectively removed a large, recurrent polyp. This technique is suitable for complex cases not treatable with conventional methods.

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Colorectal Surgery

Background:

  • Endoscopic full-thickness resection (EFTR) with the full-thickness resection device (FTRD) is established for polyps up to 30 mm.
  • Limited data exist for multistaged EFTR using FTRD in larger, recurrent, or fibrotic polyps.
  • Recurrent polyps pose management challenges, especially in difficult locations.

Purpose of the Study:

  • To evaluate the safety and efficacy of multistaged piecemeal EFTR using the FTRD for a large, recurrent polyp.
  • To demonstrate the utility of FTRD in anatomically challenging locations.

Main Methods:

  • A case report of an 85-year-old man with a 60-mm recurrent polyp near the ileocecal valve.
  • Multistaged piecemeal EFTR using the FTRD performed over 3 colonoscopies.
  • The polyp was large, fibrotic, recurrent, and in a challenging location.

Main Results:

  • Successful complete removal of the 60-mm recurrent polyp.
  • The multistaged EFTR procedure using the FTRD was completed safely.
  • No complications were reported during or after the procedures.

Conclusions:

  • Multistaged EFTR using the FTRD is a safe and effective option for large, recurrent polyps in difficult locations.
  • This technique expands endoscopic management options for complex colorectal polyps.
  • FTRD offers a viable alternative when conventional resection methods are not feasible.