EFTR WITH OTSC IN COLORECTUM: WHAT HAPPENS WHEN THE LESION IS TRAPPED IN THE OVER-THE-SCOPE-CLIP AND IS NOT RESECTED

H Uchima; D Barquero; JM Esteban; JC Espinos; JC Marin; P Rosón; F Fernandez Cadenas; MA Palacio Galan; I Puig; J Rodriguez-Sanchez; M Fraile; A Ortega; J Arribas; L Mel; F Sabado; J García Lledó; A Fernandez; A Mata; E Albeniz

doi:10.1055/s-0039-1681712

Endoscopy, Table of Contents

Endoscopy 2019; 51(04): S183
DOI: 10.1055/s-0039-1681712

ESGE Days 2019 ePoster podium presentations

Saturday, April 6, 2019 13:30 – 14:00: Colon: resection 5 ePoster Podium 2

Georg Thieme Verlag KG Stuttgart · New York

EFTR WITH OTSC IN COLORECTUM: WHAT HAPPENS WHEN THE LESION IS TRAPPED IN THE OVER-THE-SCOPE-CLIP AND IS NOT RESECTED

Authors

H Uchima

¹Gastrointestinal Endoscopy, Hospital Universitario Doctor Josep Trueta de Girona, Girona, Spain

²Gastrointestinal Endoscopy, Centro Medico Teknon, Barcelona, Spain
D Barquero

³Hospital Sant Joan Despi-Moises Broggi, Barcelona, Spain
JM Esteban

⁴Hospital Clinico San Carlos, Madrid, Spain
JC Espinos

²Gastrointestinal Endoscopy, Centro Medico Teknon, Barcelona, Spain

⁵Hospital Mutua Terrassa, Terrassa, Spain
JC Marin

⁶Gastroenterology, Hospital Universitario 12 de Octubre, Digestive System Service, Madrid, Spain
P Rosón

⁷Hospital Quiron Salud Málaga, Málaga, Spain
F Fernandez Cadenas

⁸Hospital Universitario Central de Asturias, Oviedo, Spain
MA Palacio Galan

⁸Hospital Universitario Central de Asturias, Oviedo, Spain
I Puig

⁹Althaia, Xarxa Assistencial Universitària de Manresa, Digestive System Service, Manresa, Spain
J Rodriguez-Sanchez

¹⁰Gastrointestinal Endoscopy, Hospital General Universitario Ciudad Real, Ciudad Real, Spain
M Fraile

⁸Hospital Universitario Central de Asturias, Oviedo, Spain
A Ortega

¹¹Hospital Quiron Salud Malaga, Málaga, Spain
J Arribas

⁶Gastroenterology, Hospital Universitario 12 de Octubre, Digestive System Service, Madrid, Spain
L Mel

⁴Hospital Clinico San Carlos, Madrid, Spain
F Sabado

¹²Consorcio Hospitalario Provincial Castellón, Castellón, Spain
J García Lledó

¹³Hospital Universitario Gregorio Marañón, Madrid, Spain
A Fernandez

³Hospital Sant Joan Despi-Moises Broggi, Barcelona, Spain
A Mata

²Gastrointestinal Endoscopy, Centro Medico Teknon, Barcelona, Spain

³Hospital Sant Joan Despi-Moises Broggi, Barcelona, Spain
E Albeniz

¹⁴Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit, Pamplona, Spain

Abstract

Full Text

Aims:

Endoscopic full-thickness resection (EFTR) in the colorectum using the FTRD may be difficult sometimes due to poor traction or loosing of the resection plane, and part of the lesion or the whole of it might get trapped inside the over-the-scope clip (OTSC).

Our aim was to study the outcomes of these patients with the lesion trapped in the OTSC.

Methods:

Clinical, endoscopic and histological data were collected prospectively in all cases of EFTR performed in 10 centers of Spain using the FTRD kit (Ovesco Endoscopy, Tübingen, Germany) during the period from June 2015 to July 2018.

Cases of technical failure with part or the entire lesion trapped inside the OTSC were analyzed.

Results:

68 cases of EFTR were evaluated.

In 10 cases, the lesion was trapped in the OTSC and could not be resected properly.

The mean age of the patients was 71 years, being men 80%.

Indications were: non-lifting sign recurrent lesions (6 cases), non-lifting sign untreated lesions (1), incomplete resection with non-lifting sign (2), appendicular lesions (1).

Location were appendix (1 case), stump (1), right colon (1), transverse colon (2), left colon (2), sigma (2), rectosigmoid junction (1).

The mean diameter of the lesion was 19 mm.

In 8 cases there was a partial resection of the lesion (mean diameter of the lesion 18 mm), and in 2 cases only biopsies were taken.

Final histology: LGD (4 cases), HGD (2), intramucosal adenocarcinoma (1), SSP (2), advanced adenocarcinoma >sm2 (2).

In the follow-up, three lesiones underwent surgery (appendicular lesion and advanced adenocarcinoma), 3 residual lesions were treated endoscopically and in 4 cases the scar showed no residual tissue.

Conclusions:

In some cases of intended EFTR, residual tissue trapped inside the OTSC might be easily treated endoscopically and sometimes might be treated by the OTSC itself, if the residual lesion is small.