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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(10): E1291-E1301
DOI: 10.1055/a-1216-1439
Original article

Full-thickness resection device (FTRD) for treatment of upper gastrointestinal tract lesions: the first international experience

Kaveh Hajifathalian
 1   Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, New York, NY
,
Yervant Ichkhanian
 2   Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Qais Dawod
 1   Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, New York, NY
,
Alexander Meining
 3   Interventional and Experimental Endoscopy, Department of Internal Medicine I, Ulm University, Ulm, Germany
,
Arthur Schmidt
 4   Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
,
Nicholas Glaser
 4   Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
,
Kia Vosoughi
 2   Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
David L. Diehl
 3   Interventional and Experimental Endoscopy, Department of Internal Medicine I, Ulm University, Ulm, Germany
,
Ian S. Grimm
 5   Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, United States
,
Theodore James
 6   Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, United States
,
Adam W. Templeton
 7   Department of Gastroenterology, University of Washington, Seattle, Washington, United States
,
Jason B. Samarasena
 8   H. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, United States
,
Nabil El Hage Chehade
 8   H. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, United States
,
John G. Lee
 8   H. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, United States
,
Kenneth J. Chang
 8   H. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, University of California, Irvine, Orange, California, United States
,
Meir Mizrahi
 9   Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, Alabama, United States
,
Mohammed Barawi
10   Division of Gastroenterology and Hepatology, Ascension St. John hospital, Detroit, Michigan, United States
,
Shayan Irani
11   Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, United Stats
,
Shai Friedland
12   Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, United States
,
Paul Korc
13   Department of Medicine, Division of Gastroenterology, Hoag Hospital, Newport Beach, California, United States
,
Abdul Aziz Aadam
14   Division of Gastroenterology, Northwestern University, Chicago, Illinois, United States
,
Mohammad Al-Haddad
15   Indiana University School of Medicine, Department of Medicine, Division of Gastroenterology, Indianapolis, Indiana, United States
,
Thomas E. Kowalski
16   Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
George Smallfield
17   Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, Virginia United States
,
Gregory G. Ginsberg
18   Gastroenterology Division, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
,
Norio Fukami
19   Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona, United States
,
Michael Lajin
20   SHARP Grossmont Hospital, La Mesa, California, United States
,
Nikhil A. Kumta
21   Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
,
Shou-jiang Tang
22   Division of Digestive Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
,
Yehia Naga
22   Division of Digestive Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States
,
Stuart K. Amateau
23   Division of Gastroenterology, University of Minnesota, Minneapolis, Minnesota, United States
,
Franklin Kasmin
24   Division of Gastroenterology, Lenox Hill Hospital, Northwell Health, New York, New York, United States
,
Martin Goetz
25   Innere Medizin I, Universitätsklinikum Tübingen, Tuebingen, Germany
,
Stefan Seewald
26   Centre of Gastroenterology, Klinik Hirslanden, Zurich, Switzerland
,
Vivek Kumbhari
 2   Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Saowanee Ngamruengphong
 2   Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Srihari Mahdev
 1   Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, New York, NY
,
Saurabh Mukewar
 1   Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, New York, NY
,
Kartik Sampath
 1   Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, New York, NY
,
David L. Carr-Locke
 1   Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, New York, NY
,
Mouen A. Khashab‡
 2   Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, United States
,
Reem Z. Sharaiha‡
 1   Weill Cornell Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, New York, NY
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Abstract

Background and study aims 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.

Patients and methods 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.

Results 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 %).

Conclusions 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.



Publication History

Received: 03 March 2020

Accepted: 29 June 2020

Article published online:
22 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2020; 52(11): 1043-1043
DOI: 10.1055/a-1234-8564

 

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