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Full-Thickness Resection

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Innovations in Gastrointestinal Endoscopy

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Abstract

Endoscopic full-thickness resection (EFTR) is a relatively new technique, which has greatly expanded the possibilities of endoscopic resection. It can be performed in upper and lower gastrointestinal tract. Typical indications include early mucosal neoplasms such as recurrent or residual adenomas in the colorectum, resection of subepithelial tumors (SET), and diagnostic EFTR. Different techniques can be used to perform EFTR. Exposed EFTR can be distinguished from non-exposed EFTR. In the latter case, the resection site is secured with a clip or suture prior to resection. The Full-Thickness Resection Device (FTRD) combines occlusion of resection site and resection itself in a single device. It is the best studied device for EFTR and mainly used for resection of difficult colonic adenomas. In the upper gastrointestinal tract, endoscopy and laparoscopy can be combined to achieve full-thickness resection. SETs are the major indication to perform full-thickness resection in the upper gastrointestinal tract.

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References

  1. Schmidt A, Meier B, Caca K. Endoscopic full-thickness resection: current status. World J Gastroenterol. 2015;21(31):9273–85. https://doi.org/10.3748/wjg.v21.i31.9273.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Mori H, Kobara H, Nishiyama N, Masaki T. Current status and future perspectives of endoscopic full-thickness resection. Dig Endosc. 2018;30(Suppl 1):25–31. https://doi.org/10.1111/den.13042.

    Article  PubMed  Google Scholar 

  3. Mori H, Kobara H, Fujihara S, Nishiyama N, Rafiq K, Oryu M, et al. Feasibility of pure EFTR using an innovative new endoscopic suturing device: the double-arm-bar suturing system (with video). Surg Endosc. 2014;28(2):683–90. https://doi.org/10.1007/s00464-013-3266-z.

    Article  PubMed  Google Scholar 

  4. Hiki N, Nunobe S, Matsuda T, Hirasawa T, Yamamoto Y, Yamaguchi T. Laparoscopic endoscopic cooperative surgery. Dig Endosc. 2015;27(2):197–204. https://doi.org/10.1111/den.12404.

    Article  PubMed  Google Scholar 

  5. Zhou PH, Yao LQ, Qin XY, Cai MY, Xu MD, Zhong YS, et al. Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc. 2011;25(9):2926–31. https://doi.org/10.1007/s00464-011-1644-y.

    Article  PubMed  Google Scholar 

  6. Feng Y, Yu L, Yang S, Li X, Ding J, Chen L, et al. Endolumenal endoscopic full-thickness resection of muscularis propria-originating gastric submucosal tumors. J Laparoendosc Adv Surg Tech A. 2014;24(3):171–6. https://doi.org/10.1089/lap.2013.0370.

    Article  PubMed  Google Scholar 

  7. Huang LY, Cui J, Lin SJ, Zhang B, Wu CR. Endoscopic full-thickness resection for gastric submucosal tumors arising from the muscularis propria layer. World J Gastroenterol. 2014;20(38):13981–6. https://doi.org/10.3748/wjg.v20.i38.13981.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Shi Q, Chen T, Zhong YS, Zhou PH, Ren Z, Xu MD, et al. Complete closure of large gastric defects after endoscopic full-thickness resection, using endoloop and metallic clip interrupted suture. Endoscopy. 2013;45(5):329–34. https://doi.org/10.1055/s-0032-1326214.

    Article  CAS  PubMed  Google Scholar 

  9. Ye LP, Yu Z, Mao XL, Zhu LH, Zhou XB. Endoscopic full-thickness resection with defect closure using clips and an endoloop for gastric subepithelial tumors arising from the muscularis propria. Surg Endosc. 2014;28(6):1978–83. https://doi.org/10.1007/s00464-014-3421-1.

    Article  PubMed  Google Scholar 

  10. Schlag C, Wilhelm D, von Delius S, Feussner H, Meining A. EndoResect study: endoscopic full-thickness resection of gastric subepithelial tumors. Endoscopy. 2013;45(1):4–11. https://doi.org/10.1055/s-0032-1325760.

    Article  CAS  PubMed  Google Scholar 

  11. Guo J, Liu Z, Sun S, Liu X, Wang S, Ge N, et al. Endoscopic full-thickness resection with defect closure using an over-the-scope clip for gastric subepithelial tumors originating from the muscularis propria. Surg Endosc. 2015;29(11):3356–62. https://doi.org/10.1007/s00464-015-4076-2.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chiu PW, Phee SJ, Wang Z, Sun Z, Poon CC, Yamamoto T, et al. Feasibility of full-thickness gastric resection using master and slave transluminal endoscopic robot and closure by overstitch: a preclinical study. Surg Endosc. 2014;28(1):319–24. https://doi.org/10.1007/s00464-013-3149-3.

    Article  PubMed  Google Scholar 

  13. Schmidt A, Bauder M, Riecken B, von Renteln D, Muehleisen H, Caca K. Endoscopic full-thickness resection of gastric subepithelial tumors: a single-center series. Endoscopy. 2015;47(2):154–8. https://doi.org/10.1055/s-0034-1390786.

    Article  PubMed  Google Scholar 

  14. Nunobe S, Hiki N, Gotoda T, Murao T, Haruma K, Matsumoto H, et al. Successful application of laparoscopic and endoscopic cooperative surgery (LECS) for a lateral-spreading mucosal gastric cancer. Gastric Cancer. 2012;15(3):338–42. https://doi.org/10.1007/s10120-012-0146-5.

    Article  PubMed  Google Scholar 

  15. Goto O, Takeuchi H, Kawakubo H, Sasaki M, Matsuda T, Matsuda S, et al. First case of non-exposed endoscopic wall-inversion surgery with sentinel node basin dissection for early gastric cancer. Gastric Cancer. 2015;18(2):434–9. https://doi.org/10.1007/s10120-014-0406-7.

    Article  PubMed  Google Scholar 

  16. Cho WY, Kim YJ, Cho JY, Bok GH, Jin SY, Lee TH, et al. Hybrid natural orifice transluminal endoscopic surgery: endoscopic full-thickness resection of early gastric cancer and laparoscopic regional lymph node dissection—14 human cases. Endoscopy. 2011;43(2):134–9. https://doi.org/10.1055/s-0030-1255955.

    Article  CAS  PubMed  Google Scholar 

  17. Bauder M, Schmidt A, Caca K. Endoscopic full-thickness resection of duodenal lesions-a retrospective analysis of 20 FTRD cases. United European Gastroenterol J. 2018;6(7):1015–21. https://doi.org/10.1177/2050640618773517.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kappelle WFW, Backes Y, Valk GD, Moons LMG, Vleggaar FP. Endoscopic full-thickness resection of gastric and duodenal subepithelial lesions using a new, flat-based over-the-scope clip. Surg Endosc. 2018;32(6):2839–46. https://doi.org/10.1007/s00464-017-5989-8.

    Article  PubMed  Google Scholar 

  19. Schmidt A, Bauerfeind P, Gubler C, Damm M, Bauder M, Caca K. Endoscopic full-thickness resection in the colorectum with a novel over-the-scope device: first experience. Endoscopy. 2015;47(8):719–25. https://doi.org/10.1055/s-0034-1391781.

    Article  PubMed  Google Scholar 

  20. Richter-Schrag HJ, Walker C, Thimme R, Fischer A. [Full thickness resection device (FTRD). Experience and outcome for benign neoplasms of the rectum and colon]. Chirurg. 2016;87(4):316–25. https://doi.org/10.1007/s00104-015-0091-z.

  21. Valli PV, Mertens J, Bauerfeind P. Safe and successful resection of difficult GI lesions using a novel single-step full-thickness resection device (FTRD((R))). Surg Endosc. 2018;32(1):289–99. https://doi.org/10.1007/s00464-017-5676-9.

    Article  CAS  PubMed  Google Scholar 

  22. Vitali F, Naegel A, Siebler J, Neurath MF, Rath T. Endoscopic full-thickness resection with an over-the-scope clip device (FTRD) in the colorectum: results from a university tertiary referral center. Endosc Int Open. 2018;6(1):E98–E103. https://doi.org/10.1055/s-0043-124079.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Schmidt A, Beyna T, Schumacher B, Meining A, Richter-Schrag HJ, Messmann H, et al. Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications. Gut. 2018;67(7):1280–9. https://doi.org/10.1136/gutjnl-2016-313677.

    Article  PubMed  Google Scholar 

  24. Aepli P, Criblez D, Baumeler S, Borovicka J, Frei R. Endoscopic full thickness resection (EFTR) of colorectal neoplasms with the full thickness resection device (FTRD): clinical experience from two tertiary referral centers in Switzerland. United European Gastroenterol J. 2018;6(3):463–70. https://doi.org/10.1177/2050640617728001.

    Article  PubMed  Google Scholar 

  25. Andrisani G, Soriani P, Manno M, Pizzicannella M, Pugliese F, Mutignani M, et al. Colo-rectal endoscopic full-thickness resection (EFTR) with the over-the-scope device (FTRD((R))): a multicenter Italian experience. Dig Liver Dis. 2019;51(3):375–81. https://doi.org/10.1016/j.dld.2018.09.030.

    Article  CAS  PubMed  Google Scholar 

  26. van der Spek B, Haasnoot K, Meischl C, Heine D. Endoscopic full-thickness resection in the colorectum: a single-center case series evaluating indication, efficacy and safety. Endosc Int Open. 2018;6(10):E1227–E34. https://doi.org/10.1055/a-0672-1138.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Fahndrich M, Sandmann M. Endoscopic full-thickness resection for gastrointestinal lesions using the over-the-scope clip system: a case series. Endoscopy. 2015;47(1):76–9. https://doi.org/10.1055/s-0034-1377975.

    Article  PubMed  Google Scholar 

  28. Backes Y, Kappelle WFW, Berk L, Koch AD, Groen JN, de Vos Tot Nederveen Cappel WH, et al. Colorectal endoscopic full-thickness resection using a novel, flat-base over-the-scope clip: a prospective study. Endoscopy. 2017;49(11):1092–7. https://doi.org/10.1055/s-0043-114730.

    Article  PubMed  Google Scholar 

  29. Kuellmer A, Mueller J, Caca K, Aepli P, Albers D, Schumacher B, et al. Endoscopic full-thickness resection for early colorectal cancer. Gastrointest Endosc. 2019;89(6):1180–1189.e1. https://doi.org/10.1016/j.gie.2018.12.025.

    Article  PubMed  Google Scholar 

  30. Meier B, Caca K, Schmidt A. Hybrid endoscopic mucosal resection and full-thickness resection: a new approach for resection of large non-lifting colorectal adenomas (with video). Surg Endosc. 2017;31(10):4268–74. https://doi.org/10.1007/s00464-017-5461-9.

    Article  PubMed  Google Scholar 

  31. Bronzwaer MES, Bastiaansen BAJ, Koens L, Dekker E, Fockens P. Endoscopic full-thickness resection of polyps involving the appendiceal orifice: a prospective observational case study. Endosc Int Open. 2018;6(9):E1112–E9. https://doi.org/10.1055/a-0635-0911.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Valli PV, Pohl D, Fried M, Caduff R, Bauerfeind P. Diagnostic use of endoscopic full-thickness wall resection (eFTR)—a novel minimally invasive technique for colonic tissue sampling in patients with severe gastrointestinal motility disorders. Neurogastroenterol Motil. 2018;30(1). https://doi.org/10.1111/nmo.13153.

  33. Bauder M, Meier B, Caca K, Schmidt A. Endoscopic removal of over-the-scope clips: clinical experience with a bipolar cutting device. United European Gastroenterol J. 2017;5(4):479–84. https://doi.org/10.1177/2050640616671846.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine and Gastroenterology, Hospital Ludwigsburg, Ludwigsburg, Germany

    Andreas Wannhoff & Karel Caca

  2. Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany

    Horst Neuhaus

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  1. Andreas Wannhoff
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  2. Horst Neuhaus
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  3. Karel Caca
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Correspondence to Karel Caca .

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Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Kansas School of Medicine, VA Medical Center, Kansas City, MO, USA

    Prateek Sharma

  2. Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India

    Nageshwar Reddy

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Wannhoff, A., Neuhaus, H., Caca, K. (2021). Full-Thickness Resection. In: Sharma, P., Reddy, N. (eds) Innovations in Gastrointestinal Endoscopy. Springer, Singapore. https://doi.org/10.1007/978-981-15-9247-8_10

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  • DOI: https://doi.org/10.1007/978-981-15-9247-8_10

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  • Online ISBN: 978-981-15-9247-8

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