Endoscopy 2020; 52(S 01): S86-0
DOI: 10.1055/s-0040-1704260
ESGE Days 2020 oral presentations
Friday, April 24, 2020 11:00 – 13:00 Unlock en-bloc 2 Liffey Meeting Room 2
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC FULL THICKNESS RESECTION (EFTR) VERSUS ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD) OF RESIDUAL/RECURRENT COLONIC LESIONS ON SCAR: A RETROSPECTIVE ITALIAN AND JAPANESE COMPARATIVE STUDY

F Barbaro
1   Fondazione Policlinico Universitario A. Gemelli IRCCS -Università Cattolica del Sacro Cuore, Department of Gastroenterological, Endocrino-Metabolic and Nephro-Urological Sciences, Rome, Italy
,
K Hirasawa
2   Yokohama-City Medical Center, Endoscopy, Yokohama, Japan
,
G Gibiino
3   Fondazione Policlinico Universitario A. Gemelli IRCCS -Università Cattolica del Sacro Cuore, Department of Gastroenterological, Endocrino-Metabolic and Nephro-Urological Sciences, Bologna, Italy
,
R Kobayashi
2   Yokohama-City Medical Center, Endoscopy, Yokohama, Japan
,
J Hamanaka
2   Yokohama-City Medical Center, Endoscopy, Yokohama, Japan
,
S Pecere
1   Fondazione Policlinico Universitario A. Gemelli IRCCS -Università Cattolica del Sacro Cuore, Department of Gastroenterological, Endocrino-Metabolic and Nephro-Urological Sciences, Rome, Italy
,
Ta Fukuchi
2   Yokohama-City Medical Center, Endoscopy, Yokohama, Japan
,
L Petruzziello
1   Fondazione Policlinico Universitario A. Gemelli IRCCS -Università Cattolica del Sacro Cuore, Department of Gastroenterological, Endocrino-Metabolic and Nephro-Urological Sciences, Rome, Italy
,
G Costamagna
1   Fondazione Policlinico Universitario A. Gemelli IRCCS -Università Cattolica del Sacro Cuore, Department of Gastroenterological, Endocrino-Metabolic and Nephro-Urological Sciences, Rome, Italy
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Publikationsdatum:
23. April 2020 (online)

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    Aims ESD for residual/recurrent colonic lesions on scar is technically difficult with a significant rate of perforations even in Japanese expert hands. Endoscopic full thickness resection (EFTR) with a over-the-scope device (FTRD - Ovesco Endoscopy), recently introduced in Western countries, showed to be safe and effective for residual/recurrent colonic lesions on scar . This study sought to compare outcomes for endoscopic resection of such lesions between a Japanese and an Italian tertially referral centre.

    Methods From January 2017 to July 2019 a total of 20 and 50 residual/recurrent colonic lesions on scar were treated by EFTR (in the Italian Centre) and ESD (in the Japanese Centre). En-bloc and R0-resection rates were recorded as primary outcomes and retrospectively analysed. Adverse events, median procedure time and residual lesions at 3-months follow-up were were the secondary outcomes.

    Results R0 resection rates were respectively 90% for EFTR vs 96% for ESD. En-bloc resection was achieved in 100% in both groups. Perforation rate for ESD was 24%, mainly treated conservatevely, whereas no late bleeding occurred in the entire population study. There was no significant difference in median procedure time (FTR 54 min vs ESD 66.22 min, p = 0.198). At 3-months follow-up relapse was evident in two patients of the FTR group, both treated with hybrid ESD while no relapse was reported for ESD group. Mean size of specimens was 20.95 mm for FTR (20-35 mm) vs 37.96 mm (10- 65 mm) for ESD group and histological analysis revealed 3 high-risk adenocarcinoma, all described in the Japanese population.

    Conclusions Despite the clear limitations when comparing two techniques with different advancement in asiatic and non-asiatic endoscopic centres, FTR showed to be a safe and effective procedure in residual/recurrent colonic lesions on scar and could become the standard of care in such lesions in Western Countries.


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