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Mueller, Julius [Author] ; Küllmer, Armin [Researcher]; Schmidt, Arthur [Other]; Thimme, Robert [Other]; Bettinger, Dominik [Other]; Neeff, Hannes Philipp [Other]; Schmidt, Arthur [Degree supervisor] Albert-Ludwigs-Universität Freiburg Medizinische Fakultät

Effektivität und Sicherheit bei der endoskopischen Vollwandresektion von Adenokarzinomen mit dem FTRD® - System

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  • Media type: E-Book
  • Title: Effektivität und Sicherheit bei der endoskopischen Vollwandresektion von Adenokarzinomen mit dem FTRD® - System
  • Contributor: Mueller, Julius [Author]; Küllmer, Armin [Researcher]; Schmidt, Arthur [Other]; Thimme, Robert [Other]; Bettinger, Dominik [Other]; Neeff, Hannes Philipp [Other]; Schmidt, Arthur [Degree supervisor]
  • Corporation: Albert-Ludwigs-Universität Freiburg, Medizinische Fakultät
  • Published: Freiburg: Universität, 2020
  • Extent: Online-Ressource
  • Language: German
  • DOI: 10.6094/UNIFR/165767
  • Identifier:
  • Keywords: Adenom ; Resektion ; Full Thickness Resection Device ; Colon ; Polyp ; Blinddarm ; Endoskopie ; Gastroenterologie ; (local)doctoralThesis
  • Origination:
  • University thesis: Dissertation, Universität Freiburg, 2020
  • Footnote:
  • Description: Abstract: Background and Aims<br>Current international guidelines recommend endoscopic resection for T1 colorectal cancer (CRC) with low-risk histology features and oncologic resection for those at high risk of lymphatic metastasis. Exact risk stratification is therefore crucial to avoid under-treatment as well as over-treatment. Endoscopic full-thickness resection (EFTR) has shown to be effective for treatment of non-lifting benign lesions. In this multicenter, retrospective study we aimed to evaluate efficacy, safety, and clinical value of EFTR for early CRC.<br><br>Methods<br>Records of 1234 patients undergoing EFTR for various indications at 96 centers were screened for eligibility. A total of 156 patients with histologic evidence of adenocarcinoma were identified. This cohort included 64 cases undergoing EFTR after incomplete resection of a malignant polyp (group 1) and 92 non-lifting lesions (group 2). Endpoints of the study were: technical success, R0-resection, adverse events, and successful discrimination of high-risk versus low-risk tumors.<br><br>Results<br>Technical success was achieved in 144 out of 156 (92.3%). Mean procedural time was 42 minutes. R0 resection was achieved in 112 of 156 (71.8%). Subgroup analysis showed a R0 resection rate of 87.5% in Group 1 and 60.9% in Group 2 ( P < .001). Severe procedure-related adverse events were recorded in 3.9% of patients. Discrimination between high-risk versus low-risk tumor was successful in 155 of 156 cases (99.3%). In Group 1, 84.1% were identified as low-risk lesions, whereas 16.3% in group 2 had low-risk features. In total, 53 patients (34%) underwent oncologic resection due to high-risk features whereas 98 patients (62%) were followed endoscopically.<br>Conclusions<br><br>In early colorectal cancer, EFTR is technically feasible and safe. It allows exact histological risk stratification and can avoid surgery for low-risk lesions. Prospective studies are required to further define indications for EFTR in malignant colorectal lesions and to evaluate long-term outcome
  • Access State: Open Access