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Create a Free AccountProcedures - Endoscopic submucosal dissection (ESD)
Endoscopic full-thickness resection with retroperitoneal dissection for duodenal myogenic cyst with adjustable traction from an independently controlled snare
A 58-year-old man was coincidentally found to have a duodenal subepithelial lesion in the bulb. Endoscopic ultrasonography revealed a 20-mm anechoic lesion with suspicious echogenic content or a hypoechoic lesion from the muscular propria (Figs. 1 and 2; Video 1, available online at www.giejournal.org ). Computed tomography revealed a lesion close to the hepatic hilum (Fig. 3). After a multidisciplinary discussion with endoscopists and surgeons, we decided to perform endoscopic full-thickness resection (EFTR) of the lesion with acceptable risk.Endoscopic full-thickness resection with through-the-scope suture closure for gastrointestinal stromal tumor
Gastrointestinal stromal tumors (GISTs) greater than 2 cm are considered for resection.1 Those with muscularis propria (MP) involvement, as seen on endoscopic ultrasound and/or radiology, require full-thickness resection (FTR), surgery, or a combined laparoscopic/endoscopic approach.2 Dedicated endoscopic FTR (EFTR) devices are available but limited to lesions less than 2 cm.3,4 We present a GIST resected by EFTR and through-the-scope suture (TTSS) defect closure (Video 1, available online at www.giejournal.org ).Full-thickness resection: troubleshooting, tips, and tricks for success in the colorectum
Endoscopic resection is a well-established modality for the minimally invasive treatment of superficial lesions throughout the colon and rectum. Although EMR and endoscopic submucosal dissection (ESD) provide excellent results, they have limited efficacy in certain situations, such as deeper lesions and lesions with dense submucosal fibrosis.1,2 In these situations, endoscopic full-thickness resection (EFTR) provides an alternative endoscopic resection modality, potentially sparing patients from surgical resection.Endoscopic full-thickness resection of well-differentiated T2 neuroendocrine tumors in the duodenal bulb: a case series
Endoscopic therapies have moved to the forefront in the removal of small, well-differentiated duodenal neuroendocrine tumors (NETs). Classic procedures used to address small tumors, especially those less than 1 cm in diameter, are banding without resection, ligation endoscopic mucosal resection, or endoscopic submucosal dissection. Endoscopic full-thickness resection (EFTR) is a procedure developed recently that allows for sealing off of the tissue surrounding the tumor before full-thickness removal.Hybrid resection with endoscopic submucosal dissection and full-thickness resection device of a large cecal laterally spreading tumor involving the appendix
Endoscopic submucosal dissection (ESD) allows for en bloc resection of large superficial neoplasms of the GI tract. However, ESD of lesions involving the appendix has a high risk of adverse events, even for experts.1-3 Endoscopic full-thickness resection (EFTR) using a full-thickness resection device (FTRD; Ovesco Endoscopy, Tübingen, Germany) is a new approach for these lesions, but the main limitation is tumor size.4-6 A recent case series described the hybrid ESD-EFTR technique as a rescue approach for “difficult” ESD (Fig. 1).Advanced resection and closure techniques for endoscopic full-thickness resection in the gastric fundus
Most gastric subepithelial tumors (SETs) are gastroxintestinal stromal tumors (GISTs).1 The National Comprehensive Cancer Network guidelines recommend resection of GISTs with symptoms, high-risk EUS features, or size ≥2 cm.2 Endoscopic full-thickness resection (EFTR) provides incisionless, organ-sparing, en bloc resection of SETs <5 cm.3 The gastric fundus is a challenging location for endoscopic resection and closure4 because it requires extreme retroflexion. In Asia, a “double-bending” endoscope facilitates resection in the fundus,5 but it is not available in the United States.Endoscopic full-thickness resection of a gastric GI stromal tumor
Endoscopic full-thickness resection (EFTR) is used to achieve R0 resection and comes from the need to overcome the limitations of endoscopic submucosal dissection in the management of lesions arising from, or infiltrating, the muscularis propria (subepithelial tumor) and of nonlifting or partially treated lesions.1 Several techniques have been developed over time.2,3 Initially, exposed techniques, which consist of creating an open wound followed by secure closure, were investigated. These techniques include submucosal tunneling with endoscopic resection,4,5 endoscopic submucosal excavation,6 and endoscopic full-thickness resection with secondary closure (exposed EFTR).
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