Endoscopic full-thickness resection of colorectal lesions: a 3-year experience of a Portuguese tertiary centre

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Aims Endoscopic full-thickness resection (EFTR) allows definitive diagnosis and treatment of complex colorectal lesions not amenable to conventional endoscopic resection. The authors present the results of the largest Portuguese colorectal EFTR registry. Methods Consecutive patients undergoing EFTR with a dedicated full-thickness resection device (FTRD) in a Portuguese tertiary centre were included. Data were analyzed retrospectively. Primary outcomes were technical success (macroscopic complete en bloc resection) and R0 resection. Secondary outcomes were curative resection, for histologically confirmed malignant lesions (R0 resection with no unfavorable histologic features) and adverse events. Results Between November 2020 and October 2022, 33 colorectal lesions were referred to EFTR (primary resection of suspected T1 carcinoma, n = 22; adenomas in difficult locations, n = 6; recurrent adenomas, n = 5). Technical success was achieved in 30 (90.9%) procedures. In 3 (9.1%) procedures the lesion could not be reached or retracted into the cap. In the remaining procedures, R0 resection was achieved in 24 (87.9%). Concerning histologically confirmed invasive adenocarcinoma (n = 16), curative resection rate was 43.8% (n = 7), and in additional 31.3% (n = 5) no residual cancer was found after oncologic surgery. Overall adverse event rate was 12.1% (n = 4), none of which required surgery. Conclusions EFTR is an effective and relatively safe en bloc resection technique for complex colorectal lesions, reducing surgical overtreatment of benign and malignant lesions. Publication History Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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