Technical success, resection status, and procedural complication rate of colonoscopic full-wall resection: a pooled analysis from 7 hospitals of different care levels

Krutzenbichler I, Dollhopf M, Diepolder H, Eigler A, Fuchs M, Herrmann S, Kleber G, Lewerenz B, Kaiser C, Lilje T, Rath T, Agha A, Vitali F, Schaefer C, Schepp W, Gundling F (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Surgical Endoscopy Springer Verlag (Germany)

DOI: 10.1007/s00464-020-07772-5

Abstract

Introduction: Endoscopic full-thickness resection (eFTR) using the full-thickness resection device (FTRD®) is a novel minimally invasive procedure that allows the resection of various lesions in the gastrointestinal tract including the colorectum. Real-world data outside of published studies are limited. The aim of this study was a detailed analysis of the outcomes of colonoscopic eFTR in different hospitals from different care levels in correlation with the number of endoscopists performing eFTR. Material and methods: In this case series, the data of all patients who underwent eFTR between November 2014 and June 2019 (performed by a total of 22 endoscopists) in 7 hospitals were analyzed retrospectively regarding rates of technical success, R0 resection, and procedure-related complications. Results: Colonoscopic eFTR was performed in 229 patients (64.6% men; average age 69.3 ± 10.3 years) mainly on the basis of the following indication: 69.9% difficult adenomas, 21.0% gastrointestinal adenocarcinomas, and 7.9% subepithelial tumors. The average size of the lesions was 16.3 mm. Technical success rate of eFTR was achieved in 83.8% (binominal confidence interval 78.4–88.4%). Overall, histologically complete resection (R0) was achieved in 77.2% (CI 69.8–83.6%) while histologically proven full-wall excidate was confirmed in 90.0% (CI 85.1–93.7%). Of the resectates obtained (n = 210), 190 were resected en bloc (90.5%). We did not observe a clear improvement of technical success and R0 resection rate over time by the performing endoscopists. Altogether, procedure-related complications were observed in 17.5% (mostly moderate) including 2 cases of acute gangrenous appendicitis requiring operation. Discussion: In this pooled analysis, eFTR represents a feasible, effective, and safe minimally invasive endoscopic technique.

Authors with CRIS profile

Timo Rath Juniorprofessur für Molekulare Endoskopie Francesco Vitali Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology

Involved external institutions

Technische Universität München (TUM) DE Germany (DE) Klinikum Neuperlach DE Germany (DE) Kliniken Ostallgäu-Kaufbeuren Anstalt des öffentlichen Rechts Buchloe - Füssen - Kaufbeuren DE Germany (DE) Klinikum Dritter Orden DE Germany (DE) Ostalb-Klinikum Aalen DE Germany (DE) Kliniken des Landkreises Neumarkt i.d.OPf. DE Germany (DE)

How to cite

APA:

Krutzenbichler, I., Dollhopf, M., Diepolder, H., Eigler, A., Fuchs, M., Herrmann, S.,... Gundling, F. (2020). Technical success, resection status, and procedural complication rate of colonoscopic full-wall resection: a pooled analysis from 7 hospitals of different care levels. Surgical Endoscopy. https://doi.org/10.1007/s00464-020-07772-5

MLA:

Krutzenbichler, Irmengard, et al. "Technical success, resection status, and procedural complication rate of colonoscopic full-wall resection: a pooled analysis from 7 hospitals of different care levels." Surgical Endoscopy (2020).

BibTeX: Download