Ann Ital Chir. 2020;91:486-493.
Aim of our observational and retrospective study is to compare efficacy and indications of endoscopic full-thickness resection device (FTRD) with the over-the-scope (OVESCO) clip closure for en bloc resection of colorectal lesions (including adenomas, early carcinomas, inflammatory polyps and neuroendocrine tumors).
This article collected 36 cases of colorectal neoplasms from a single Italian referral center per colorectal disease treatment. Primary endpoints included en bloc resection, R0 resection and an early discharge of the patient. Secondary endpoints included procedure-related adverse events.
Mean procedure time± standard deviation (SD) was 19.6±22.1 minutes and mean hospital stay (± SD) was 2.2±1.1 days. Overall, an en bloc resection was achieved in 34 cases (94.4%), with an R0 resection rate of 91.6%. Among the three not R0 patients, further additional treatments were needed.
Along the same line of other already published articles, the main current indications of EFTR by FTRD-OVESCO are limited to superficial or low-risk malignancy lesions (eg, adenomas, early cancers or subepithelial tumors), not suitable to conventional endoscopic resection or in patients with a severe surgical risk. Both en bloc resection rate and complication rate are aligned with other authors' data.
EFTR by FTRD system represents an effective and safe options whenever a recurrent lesion in a challenging environment occurres (eg, recent scar, low rectum or beyond a large colonic bend). Procedure-related adverse events are potentially severe, so that this novel technique should be performed by "expert hands".
Difficult polypectomies, Early carcinomas, Endoscopic Full-Thickness Resection (EFTR), Full-Thickness Resection Device (FTRD) by Over-The-Scope (OVESCO) clip closure, Literature overview, Single center experience.
本观察性和回顾性研究的目的是比较内镜全层切除术（FTRD）与内镜下全层切除术（FTRD）联合过内镜（OVESCO）夹闭合术治疗结直肠病变（包括腺瘤、早期癌、炎性息肉和神经内分泌肿瘤）的疗效和适应证。
本文收集了一家意大利转诊中心治疗结直肠疾病的 36 例结直肠肿瘤病例。主要终点包括整块切除、R0 切除和患者早期出院。次要终点包括与操作相关的不良事件。
平均手术时间±标准差（SD）为 19.6±22.1 分钟，平均住院时间（±SD）为 2.2±1.1 天。总体上，34 例（94.4%）实现了整块切除，R0 切除率为 91.6%。在 3 例非 R0 患者中，需要进一步的额外治疗。
与其他已发表的文章一致，FTRD-OVESCO 的 EFTR 的主要适应证限于表浅或低风险恶性肿瘤病变（如腺瘤、早期癌或黏膜下肿瘤），不适合常规内镜切除或患者手术风险高。整块切除率和并发症发生率与其他作者的数据一致。
当在具有挑战性的环境中出现复发性病变时（如近期疤痕、低位直肠或结肠大弯处），FTRD 系统的 EFTR 是一种有效且安全的选择。与操作相关的不良事件可能很严重，因此这种新技术应由“专家”来进行。
困难性息肉切除术；早期癌；内镜全层切除术（EFTR）；过内镜（OVESCO）夹闭合术的全层切除术（FTRD）；文献综述；单中心经验。
