Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Dig Endosc. 2018 Apr;30 Suppl 1:25-31. doi: 10.1111/den.13042.
Flexible endoscopy has developed from a diagnostic tool for tissue biopsy sampling to a treatment tool for endoscopic resection of neoplasms in the digestive tract. In the near future, one of the advanced endoscopic techniques, endoscopic full-thickness resection (EFTR), is expected to be a feasible endoscopic procedure. In the present review, systematic review of conventional exposed EFTR was carried out. Search queries were (endoscopic full-thickness resection or EFTR) (over-the-scope clip or OTSC) (Overstitch System) from 2015 to 2017. Four retrospective, single-center studies with regard to conventional EFTR were identified. With regard to indication for conventional exposed EFTR, gastrointestinal stromal tumor was a good indication for EFTR. Mean tumor size of all four studies was 20.71 mm. In two studies, endoclips were used to close the resected opening without any complications, but the other two studies reported complications such as delayed perforation even using OTSC. Procedure times were reported from a minimum of 40 min to a maximum of 105 min. We also refer to introduction of a newly developed procedure of EFTR (non-exposed EFTR), and development of a new suturing device in Japan.
内镜下治疗已从组织活检的诊断工具发展为消化道肿瘤的内镜下切除治疗工具。在不久的将来，内镜下全层切除术（EFTR）有望成为一种可行的内镜治疗方法。本综述对传统内镜下 EFTR 进行了系统评价。检索词为（内镜下全层切除术或 EFTR）（经内镜隧道切除吻合器或 OTSC）（Overstitch 系统），检索时间为 2015 年至 2017 年。共检索到 4 项关于传统 EFTR 的回顾性单中心研究。关于传统 EFTR 的适应证，胃肠道间质瘤是 EFTR 的一个很好的适应证。四项研究的平均肿瘤大小均为 20.71mm。在两项研究中，使用夹闭器封闭切除口，无任何并发症，但其他两项研究报告了并发症，如使用 OTSC 后出现延迟穿孔。手术时间最短为 40 分钟，最长为 105 分钟。我们还介绍了 EFTR 的一种新的操作方法（非暴露性 EFTR），以及日本一种新的缝合设备的发展。
