Manti Magdalini, Papaefthymiou Apostolis, Dritsas Spyridon, Kamperidis Nikolaos, Papanikolaou Ioannis S, Paraskeva Konstantina, Facciorusso Antonio, Triantafyllou Konstantinos, Papadopoulos Vasilios, Tziatzios Georgios, Gkolfakis Paraskevas
Gastroenterology Unit, St Mark's Hospital, Acton Ln, London NW10 7NS, UK.
Department of Gastroenterology, General University Hospital of Larissa, 41334 Larissa, Greece.
Diagnostics (Basel). 2025 Apr 4;15(7):932. doi: 10.3390/diagnostics15070932.
Endoscopic full-thickness resection (EFTR) has emerged as a transformative technique for managing gastrointestinal (GI) lesions, previously deemed unsuitable for endoscopic removal. Unlike conventional endoscopic resection methods, such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), EFTR enables en bloc excision of both intraluminal and subepithelial lesions by resecting all layers of the GI wall, followed by defect closure to prevent complications. The introduction of the full-thickness resection device (FTRD) has significantly enhanced the feasibility and safety of EFTR, particularly in the colon and upper GI tract, with increasing adoption worldwide. This review provides a comprehensive analysis of FTRD, focusing on its clinical applications, procedural methodology, and comparative efficacy against other endoscopic resection techniques. The indications and contraindications for EFTR are explored, highlighting its utility in treating non-lifting adenomas, subepithelial tumours, and T1 carcinomas without lymph node involvement. This review synthesizes current clinical data and FTRD advantages. Despite its strengths, EFTR via FTRD incorporates challenges such as limitations in lesion size, procedural complexity, and potential adverse events. Strategies for overcoming these challenges, including hybrid techniques and modifications in procedural approach, are examined. The review also emphasizes the need for further research to optimize surveillance strategies and determine the long-term clinical impact of EFTR in GI lesion management. By integrating recent evidence, this paper provides valuable insights into the evolving role of EFTR in therapeutic endoscopy.
内镜全层切除术（EFTR）已成为一种变革性技术，用于处理以前被认为不适合内镜切除的胃肠道（GI）病变。与传统的内镜切除方法，如内镜黏膜切除术（EMR）和内镜黏膜下剥离术（ESD）不同，EFTR能够通过切除胃肠道壁的所有层次，整块切除腔内和上皮下病变，随后封闭缺损以预防并发症。全层切除装置（FTRD）的引入显著提高了EFTR的可行性和安全性，尤其是在结肠和上消化道，在全球范围内的应用越来越广泛。本综述对FTRD进行了全面分析，重点关注其临床应用、操作方法以及与其他内镜切除技术相比的疗效。探讨了EFTR的适应证和禁忌证，强调了其在治疗无抬举性腺瘤、上皮下肿瘤以及无淋巴结转移的T1期癌方面的效用。本综述综合了当前的临床数据和FTRD的优势。尽管EFTR有其优点，但通过FTRD进行的EFTR也存在一些挑战，如病变大小的限制、操作复杂性以及潜在的不良事件。研究了克服这些挑战的策略，包括混合技术和操作方法的改进。该综述还强调需要进一步研究以优化监测策略，并确定EFTR在胃肠道病变管理中的长期临床影响。通过整合最新证据，本文为EFTR在治疗性内镜检查中不断演变的作用提供了有价值的见解。
