Novel endoscopic full-thickness resection device safe, effective for colorectal lesions

A recent study has demonstrated the safety and effectiveness of a full-thickness resection device (FTRD) for endoscopic full-thickness resection (eFTR) of difficult colorectal lesions.

“EFTR is a field of increasing interest that offers a minimally invasive resection modality for lesions that are not amenable for resection by conventional methods,” the authors said. “FTRD is a new device that was developed for a single-step eFTR using an over-the scope-clip.”

A comprehensive literature review of different databases was performed to identify studies reporting FTRD with outcomes of interest, excluding those with <10 cases. The authors extracted the rates of histologic complete resection (R0), technical success, and complications. They assessed efficacy using the technical and the R0 rates and safety using the complication rates.

Nine studies encompassing 551 patients with 555 lesions met the eligibility criteria. The weighted pooled rate (WPR) for overall R0 was 82.4 percent (95 percent confidence interval [CI], 79.0–85.5 percent), with moderate heterogeneity (I², 34.8 percent); for technical success and total complications rates, the WPRs were 89.25 percent (95 percent CI, 86.4–91.7 percent), with low heterogeneity (I², 23.7 percent), and 10.2 percent (95 percent CI, 7.8–12.8 percent), with no heterogeneity, respectively.

The respective pooled rates for minor bleeding, major bleeding, postpolypectomy syndrome, and perforation were 3.2 percent, 0.97 percent, 2.2 percent, and 1.2 percent. Of the 44 periappendicular lesions, the pooled rate was 19.7 percent for acute appendicitis.

“Large prospective studies comparing FTRD with conventional resection techniques are warranted,” the authors said.