1. Outcomes of a hybrid technique using EMR and endoscopic full-thickness resection for polyps not amenable to standard techniques (with video)
- Author
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Ashley A. Vareedayah, William Yuen, Srihari Mahadev, Sofia Yuen, Kristen Koller, and Gregory B. Haber
- Subjects
Adenoma ,medicine.medical_specialty ,Endoscopic Mucosal Resection ,Technical success ,Complete resection ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Full thickness resection ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Endoscopy ,Retrospective cohort study ,medicine.disease ,Hybrid approach ,Treatment Outcome ,Dysplasia ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Radiology ,business - Abstract
The full-thickness resection device (FTRD) offers a safe and effective approach for resection of complex colorectal lesions but is limited to lesions 2 cm in size. A hybrid approach-combining EMR with the FTRD-significantly expands the pool of lesions amenable to this technique; however, its safety and efficacy has not been well established.We report a single-center retrospective study of consecutive patients who underwent full-thickness resection (FTR) of colorectal lesions, either with a standalone FTRD or a hybrid (EMR + FTRD) approach. Outcomes of technical success, clinical success (macroscopically complete resection), R0 resection, and adverse events (AEs) were evaluated.Sixty-nine FTR procedures (38 standalone FTR and 31 hybrid EMR + FTR) were performed on 65 patients. The most common indications were nonlifting polyp (43%) or suspected high-grade dysplasia or carcinoma (38%). Hybrid EMR + FTR permitted resection of significantly larger lesions (mean, 39 mm; range, 15-70 mm) compared with standalone FTR (mean, 17 mm; range, 7-25 mm; P .01). Clinical success (91%), technical success (83%), and R0 resection (81%) rates did not differ between standalone and hybrid groups. Most patients (96%) were discharged home on the day of the procedure. Three AEs occurred, including 2 patients who developed acute appendicitis.A hybrid approach combining EMR and FTRD maintains safety and efficacy while permitting resection of significantly larger lesions than FTRD alone.
- Published
- 2021