Background and aimsEndoscopic treatment of recurrent/residual colonic lesions on scars is a challenging procedure. In this setting, endoscopic submucosal dissection (ESD) is considered the first choice, despite a significant rate of complications. Endoscopic full-thickness resection (eFTR) has been shown to be well-tolerated and effective for these lesions. The aim of this study is to conduct a comparison of outcomes for resection of such lesions between ESD and eFTR in an Italian and a Japanese referral center.MethodsFrom January 2018 to July 2020, we retrospectively enrolled patients with residual/recurrent colonic lesions, 20 treated by eFTR in Italy and 43 treated by ESD in Japan. The primary outcome was to compare the two techniques in terms of en-bloc and R0-resection rates, whereas complications, time of procedure, and outcomes at 3-month follow-up were evaluated as secondary outcomes.ResultsR0 resection rate was not significantly different between the two groups [18/20 (90%) and 41/43 (95%); P= 0.66]. En-bloc resection was 100% in both groups. No significant difference was found in the procedure time (54 min vs. 61 min; P= 0.9). There was a higher perforation rate in the ESD group [11/43 (26%) vs. 0/20 (0%); P= 0.01]. At the 3-month follow-up, two lesions relapsed in the eFTR cohort and none in the ESD cohort (P= 0.1).ConclusioneFTR is a safer, as effective and equally time-consuming technique compared with ESD for the treatment of residual/recurrent colonic lesions on scars and could become an alternative therapeutic option for such lesions.

Barbaro, F., Papparella, L. G., Chiappetta, M. F., Ciuffini, C., Fukuchi, T., Hamanaka, J., Quero, G., Pecere, S., Gibiino, G., Petruzziello, L., Maeda, S., Hirasawa, K., Costamagna, G., Endoscopic full-thickness resection vs. endoscopic submucosal dissection of residual/recurrent colonic lesions on scars: a retrospective Italian and Japanese comparative study, <<EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY>>, 2023; 36 (2): 162-167. [doi:10.1097/MEG.0000000000002684] [https://hdl.handle.net/10807/280137]

Endoscopic full-thickness resection vs. endoscopic submucosal dissection of residual/recurrent colonic lesions on scars: a retrospective Italian and Japanese comparative study

Barbaro, Federico;Papparella, Luigi Giovanni;Quero, Giuseppe;Pecere, Silvia;Petruzziello, Lucio;Costamagna, Guido
2024

Abstract

Background and aimsEndoscopic treatment of recurrent/residual colonic lesions on scars is a challenging procedure. In this setting, endoscopic submucosal dissection (ESD) is considered the first choice, despite a significant rate of complications. Endoscopic full-thickness resection (eFTR) has been shown to be well-tolerated and effective for these lesions. The aim of this study is to conduct a comparison of outcomes for resection of such lesions between ESD and eFTR in an Italian and a Japanese referral center.MethodsFrom January 2018 to July 2020, we retrospectively enrolled patients with residual/recurrent colonic lesions, 20 treated by eFTR in Italy and 43 treated by ESD in Japan. The primary outcome was to compare the two techniques in terms of en-bloc and R0-resection rates, whereas complications, time of procedure, and outcomes at 3-month follow-up were evaluated as secondary outcomes.ResultsR0 resection rate was not significantly different between the two groups [18/20 (90%) and 41/43 (95%); P= 0.66]. En-bloc resection was 100% in both groups. No significant difference was found in the procedure time (54 min vs. 61 min; P= 0.9). There was a higher perforation rate in the ESD group [11/43 (26%) vs. 0/20 (0%); P= 0.01]. At the 3-month follow-up, two lesions relapsed in the eFTR cohort and none in the ESD cohort (P= 0.1).ConclusioneFTR is a safer, as effective and equally time-consuming technique compared with ESD for the treatment of residual/recurrent colonic lesions on scars and could become an alternative therapeutic option for such lesions.
2024
Inglese
Barbaro, F., Papparella, L. G., Chiappetta, M. F., Ciuffini, C., Fukuchi, T., Hamanaka, J., Quero, G., Pecere, S., Gibiino, G., Petruzziello, L., Maeda, S., Hirasawa, K., Costamagna, G., Endoscopic full-thickness resection vs. endoscopic submucosal dissection of residual/recurrent colonic lesions on scars: a retrospective Italian and Japanese comparative study, <<EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY>>, 2023; 36 (2): 162-167. [doi:10.1097/MEG.0000000000002684] [https://hdl.handle.net/10807/280137]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/280137
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