A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions

Y. Ichkhanian; K. Vosoughi; D. L. Diehl; I. S. Grimm; T. W. James; A. W. Templeton; K. Hajifathalian; J. L. Tokar; J. B. Samarasena; N. El Hage Chehade; J. Lee; K. Chang; M. Mizrahi; M. Barawi; S. Irani; S. Friedland; P. Korc; A. A. Aadam; M. A. Al-Haddad; T. E. Kowalski; A. Novikov; G. Smallfield; G. G. Ginsberg; V. M. Oza; D. Panuu; N. Fukami; H. Pohl; Michael Lajin; N. A. Kumta; S. J. Tang; Y. M. Naga; S. K. Amateau; G. O.I. Brewer; V. Kumbhari; R. Sharaiha; Mouen A. Khashab

doi:10.1007/s00464-020-07504-9

A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions

Y. Ichkhanian, K. Vosoughi, D. L. Diehl, I. S. Grimm, T. W. James, A. W. Templeton, K. Hajifathalian, J. L. Tokar, J. B. Samarasena, N. El Hage Chehade, J. Lee, K. Chang, M. Mizrahi, M. Barawi, S. Irani, S. Friedland, P. Korc, A. A. Aadam, M. A. Al-Haddad, T. E. KowalskiA. Novikov, G. Smallfield, G. G. Ginsberg, V. M. Oza, D. Panuu, N. Fukami, H. Pohl, Michael Lajin, N. A. Kumta, S. J. Tang, Y. M. Naga, S. K. Amateau, G. O.I. Brewer, V. Kumbhari, R. Sharaiha, Mouen A. Khashab

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3 Scopus citations

Abstract

Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.

Original language	English (US)
Pages (from-to)	1296-1306
Number of pages	11
Journal	Surgical endoscopy
Volume	35
Issue number	3
DOIs	https://doi.org/10.1007/s00464-020-07504-9
State	Published - Mar 2021

Keywords

Difficult adenomas
Endoscopic full-thickness resection
FTRD
Full-thickness resection device

ASJC Scopus subject areas

Surgery

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10.1007/s00464-020-07504-9

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Ichkhanian, Y., Vosoughi, K., Diehl, D. L., Grimm, I. S., James, T. W., Templeton, A. W., Hajifathalian, K., Tokar, J. L., Samarasena, J. B., Chehade, N. E. H., Lee, J., Chang, K., Mizrahi, M., Barawi, M., Irani, S., Friedland, S., Korc, P., Aadam, A. A., Al-Haddad, M. A., ... Khashab, M. A. (2021). A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions. Surgical endoscopy, 35(3), 1296-1306. https://doi.org/10.1007/s00464-020-07504-9

Ichkhanian, Y, Vosoughi, K, Diehl, DL, Grimm, IS, James, TW, Templeton, AW, Hajifathalian, K, Tokar, JL, Samarasena, JB, Chehade, NEH, Lee, J, Chang, K, Mizrahi, M, Barawi, M, Irani, S, Friedland, S, Korc, P, Aadam, AA, Al-Haddad, MA, Kowalski, TE, Novikov, A, Smallfield, G, Ginsberg, GG, Oza, VM, Panuu, D, Fukami, N, Pohl, H, Lajin, M, Kumta, NA, Tang, SJ, Naga, YM, Amateau, SK, Brewer, GOI, Kumbhari, V, Sharaiha, R & Khashab, MA 2021, 'A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions', Surgical endoscopy, vol. 35, no. 3, pp. 1296-1306. https://doi.org/10.1007/s00464-020-07504-9

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title = "A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions",

abstract = "Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.",

keywords = "Difficult adenomas, Endoscopic full-thickness resection, FTRD, Full-thickness resection device",

author = "Y. Ichkhanian and K. Vosoughi and Diehl, {D. L.} and Grimm, {I. S.} and James, {T. W.} and Templeton, {A. W.} and K. Hajifathalian and Tokar, {J. L.} and Samarasena, {J. B.} and Chehade, {N. El Hage} and J. Lee and K. Chang and M. Mizrahi and M. Barawi and S. Irani and S. Friedland and P. Korc and Aadam, {A. A.} and Al-Haddad, {M. A.} and Kowalski, {T. E.} and A. Novikov and G. Smallfield and Ginsberg, {G. G.} and Oza, {V. M.} and D. Panuu and N. Fukami and H. Pohl and Michael Lajin and Kumta, {N. A.} and Tang, {S. J.} and Naga, {Y. M.} and Amateau, {S. K.} and Brewer, {G. O.I.} and V. Kumbhari and R. Sharaiha and Khashab, {Mouen A.}",

note = "Publisher Copyright: {\textcopyright} 2020, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2021",

month = mar,

doi = "10.1007/s00464-020-07504-9",

language = "English (US)",

volume = "35",

pages = "1296--1306",

journal = "Surgical endoscopy",

issn = "0930-2794",

publisher = "Springer New York",

number = "3",

}

TY - JOUR

T1 - A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions

AU - Ichkhanian, Y.

AU - Vosoughi, K.

AU - Diehl, D. L.

AU - Grimm, I. S.

AU - James, T. W.

AU - Templeton, A. W.

AU - Hajifathalian, K.

AU - Tokar, J. L.

AU - Samarasena, J. B.

AU - Chehade, N. El Hage

AU - Lee, J.

AU - Chang, K.

AU - Mizrahi, M.

AU - Barawi, M.

AU - Irani, S.

AU - Friedland, S.

AU - Korc, P.

AU - Aadam, A. A.

AU - Al-Haddad, M. A.

AU - Kowalski, T. E.

AU - Novikov, A.

AU - Smallfield, G.

AU - Ginsberg, G. G.

AU - Oza, V. M.

AU - Panuu, D.

AU - Fukami, N.

AU - Pohl, H.

AU - Lajin, Michael

AU - Kumta, N. A.

AU - Tang, S. J.

AU - Naga, Y. M.

AU - Amateau, S. K.

AU - Brewer, G. O.I.

AU - Kumbhari, V.

AU - Sharaiha, R.

AU - Khashab, Mouen A.

PY - 2021/3

Y1 - 2021/3

N2 - Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.

AB - Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.

KW - Difficult adenomas

KW - Endoscopic full-thickness resection

KW - FTRD

KW - Full-thickness resection device

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U2 - 10.1007/s00464-020-07504-9

DO - 10.1007/s00464-020-07504-9

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AN - SCOPUS:85081594200

SN - 0930-2794

VL - 35

SP - 1296

EP - 1306

JO - Surgical endoscopy

JF - Surgical endoscopy

IS - 3

ER -

A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions

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