Khataniar Himsikhar, Desai Aakash, Kochhar Gursimran S
Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA.
Department of Gastroenterology, Hepatology and Nutrition, Allegheny Health Network, Pittsburgh, PA.
ACG Case Rep J. 2024 Dec 20;11(12):e01571. doi: 10.14309/crj.0000000000001571. eCollection 2024 Dec.
Endoscopic full-thickness resection (EFTR) is a novel endoscopic technique for removing complex colorectal lesions. The inflammatory bowel disease (IBD) population poses unique challenges for endoscopic resection due to an increased prevalence of fibrotic, nonlifting lesions and higher recurrence rates compared with the general population. This case series reports on the successful use of EFTR in 5 patients with IBD who had challenging colonic polyps, including fibrotic and nonlifting lesions. Technical success was achieved in all cases without any postoperative complications. Follow-up surveillance revealed no residual lesions or recurrence, and histopathological analysis confirmed full-thickness resection in all samples. This is one of the first case series suggesting that EFTR is a promising, safe, and effective alternative to surgery for managing complex colorectal polyps in patients with IBD.
内镜全层切除术(EFTR)是一种用于切除复杂结直肠病变的新型内镜技术。由于与普通人群相比,炎症性肠病(IBD)患者中纤维化、不可提起病变的患病率增加且复发率更高,因此该人群在内镜切除方面面临独特挑战。本病例系列报道了5例患有具有挑战性的结肠息肉(包括纤维化和不可提起病变)的IBD患者成功使用EFTR的情况。所有病例均取得技术成功,且无任何术后并发症。随访监测未发现残留病变或复发,组织病理学分析证实所有样本均为全层切除。这是首批病例系列之一,表明EFTR是治疗IBD患者复杂结直肠息肉的一种有前景、安全且有效的手术替代方法。