Hajifathalian Kaveh, Ichkhanian Yervant, Dawod Qais, Meining Alexander, Schmidt Arthur, Glaser Nicholas, Vosoughi Kia, Diehl David L, Grimm Ian S, James Theodore, Templeton Adam W, Samarasena Jason B, Chehade Nabil El Hage, Lee John G, Chang Kenneth J, Mizrahi Meir, Barawi Mohammed, Irani Shayan, Friedland Shai, Korc Paul, Aadam Abdul Aziz, Al-Haddad Mohammad, Kowalski Thomas E, Smallfield George, Ginsberg Gregory G, Fukami Norio, Lajin Michael, Kumta Nikhil A, Tang Shou-Jiang, Naga Yehia, Amateau Stuart K, Kasmin Franklin, Goetz Martin, Seewald Stefan, Kumbhari Vivek, Ngamruengphong Saowanee, Mahdev Srihari, Mukewar Saurabh, Sampath Kartik, Carr-Locke David L, Khashab Mouen A, Sharaiha Reem Z
Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, New York, NY.
Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States.
Endosc Int Open. 2020 Oct;8(10):E1291-E1301. doi: 10.1055/a-1216-1439. Epub 2020 Sep 22.
The Full-Thickness Resection Device (FTRD) provides a novel treatment option for lesions not amenable to conventional endoscopic resection techniques. There are limited data on the efficacy and safety of FTRD for resection of upper gastrointestinal tract (GIT) lesions. This was an international multicenter retrospective study, including patients who had an endoscopic resection of an upper GIT lesion using the FTRD between January 2017 and February 2019. Fifty-six patients from 13 centers were included. The most common lesions were mesenchymal neoplasms (n = 23, 41 %), adenomas (n = 7, 13 %), and hamartomas (n = 6, 11 %). Eighty-four percent of lesions were located in the stomach, and 14 % in the duodenum. The average size of lesions was 14 mm (range 3 to 33 mm). Deployment of the FTRD was technically successful in 93 % of patients (n = 52) leading to complete and partial resection in 43 (77 %) and 9 (16 %) patients, respectively. Overall, the FTRD led to negative histological margins (R0 resection) in 38 (68 %) of patients. A total of 12 (21 %) mild or moderate adverse events (AEs) were reported. Follow-up endoscopy was performed in 31 patients (55 %), on average 88 days after the procedure (IQR 68-138 days). Of these, 30 patients (97 %) did not have any residual or recurrent lesion on endoscopic examination and biopsy, with residual adenoma in one patient (3 %). Our results suggest a high technical success rate and an acceptable histologically complete resection rate, with a low risk of AEs and early recurrence for FTRD resection of upper GIT lesions.
全层切除装置（FTRD）为不适用于传统内镜切除技术的病变提供了一种新的治疗选择。关于FTRD切除上消化道（GIT）病变的疗效和安全性的数据有限。这是一项国际多中心回顾性研究，纳入了2017年1月至2019年2月期间使用FTRD进行上消化道病变内镜切除的患者。来自13个中心的56例患者被纳入。最常见的病变是间质性肿瘤（n = 23，41%）、腺瘤（n = 7，13%）和错构瘤（n = 6，11%）。84%的病变位于胃，14%位于十二指肠。病变的平均大小为14毫米（范围3至33毫米）。93%的患者（n = 52）FTRD的部署在技术上成功，分别导致43例（77%）患者完全切除和9例（16%）患者部分切除。总体而言，FTRD使38例（68%）患者的组织学切缘阴性（R0切除）。共报告了12例（21%）轻度或中度不良事件（AE）。31例患者（55%）进行了随访内镜检查，平均在手术后88天（IQR 68 - 138天）。其中，30例患者（97%）在内镜检查和活检中没有任何残留或复发病变，1例患者（3%）有残留腺瘤。我们的结果表明，FTRD切除上消化道病变具有较高的技术成功率和可接受的组织学完全切除率，不良事件风险低且早期复发率低。
