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Hépato-Gastro & Oncologie Digestive

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Endoscopic full-thickness resection for colorectal lesions using the new FTRD® device: indications, technic, results and limitations Volume 24, issue 3, Mars 2017

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Authors
CHU Henri Mondor,
département de gastroentérologie,
51,
avenue du Maréchal de Lattre de Tassigny 94000 Créteil,
France
* Tirés à part

A new endoscopic device (FTRD®, Ovesco Endoscopy, Germany) allows a full-thickness endoscopic resection of colorectal lesions, by allowing simultaneously full thickness section of colorectal wall and closure of the resection site using a modified over the scope OTSC clip. The FTRD® device is a pre-assembled over-the-scope device that can be mounted over a standard colonoscope. Main indications are: recurrent adenomas with negative lifting sign, non-lifting adenomas without previous treatment, complementary resection of a T1-carcinoma, adenomas at difficult anatomic locations, subepithelial tumors and diagnostic resections in patients with suspected motility disorders (Hirschsprung's disease). In the last published studies, full-thickness resection was successful in 83% to 100%, with a complete histological resection (R0) in 75% to 100%. Few post-procedure complications have been reported including one case of perforation treated medically and no massive bleeding. This procedure seems rather fast with a median procedure time of 50 minutes. Main limitations are: the diameter of the cap limiting maximal size of the resection and the rigidity and length of the cap limiting endoscopic view and flexibility of the endoscope tip.