PMID- 33592228
OWN - NLM
STAT- MEDLINE
DCOM- 20210810
LR  - 20211014
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 94
IP  - 2
DP  - 2021 Aug
TI  - Outcomes of a hybrid technique using EMR and endoscopic full-thickness resection 
      for polyps not amenable to standard techniques (with video).
PG  - 358-367.e1
LID - S0016-5107(21)00130-9 [pii]
LID - 10.1016/j.gie.2021.02.009 [doi]
AB  - BACKGROUND AND AIMS: The full-thickness resection device (FTRD) offers a safe and 
      effective approach for resection of complex colorectal lesions but is limited to 
      lesions <2 cm in size. A hybrid approach-combining EMR with the 
      FTRD-significantly expands the pool of lesions amenable to this technique; 
      however, its safety and efficacy has not been well established. METHODS: We 
      report a single-center retrospective study of consecutive patients who underwent 
      full-thickness resection (FTR) of colorectal lesions, either with a standalone 
      FTRD or a hybrid (EMR + FTRD) approach. Outcomes of technical success, clinical 
      success (macroscopically complete resection), R0 resection, and adverse events 
      (AEs) were evaluated. RESULTS: Sixty-nine FTR procedures (38 standalone FTR and 
      31 hybrid EMR + FTR) were performed on 65 patients. The most common indications 
      were nonlifting polyp (43%) or suspected high-grade dysplasia or carcinoma (38%). 
      Hybrid EMR + FTR permitted resection of significantly larger lesions (mean, 
      39 mm; range, 15-70 mm) compared with standalone FTR (mean, 17 mm; range, 
      7-25 mm; P < .01). Clinical success (91%), technical success (83%), and R0 
      resection (81%) rates did not differ between standalone and hybrid groups. Most 
      patients (96%) were discharged home on the day of the procedure. Three AEs 
      occurred, including 2 patients who developed acute appendicitis. CONCLUSIONS: A 
      hybrid approach combining EMR and FTRD maintains safety and efficacy while 
      permitting resection of significantly larger lesions than FTRD alone.
CI  - Copyright (c) 2021. Published by Elsevier Inc.
FAU - Mahadev, SriHari
AU  - Mahadev S
AD  - Division of Gastroenterology & Hepatology, Department of Medicine, Weill Cornell 
      Medicine, New York, New York, USA.
FAU - Vareedayah, Ashley A
AU  - Vareedayah AA
AD  - Division of Gastroenterology & Hepatology, Department of Medicine, New York 
      University Langone Health, New York, New York, USA.
FAU - Yuen, Sofia
AU  - Yuen S
AD  - Division of Gastroenterology & Hepatology, Department of Medicine, New York 
      University Langone Health, New York, New York, USA.
FAU - Yuen, William
AU  - Yuen W
AD  - Division of Gastroenterology & Hepatology, Department of Medicine, New York 
      University Langone Health, New York, New York, USA.
FAU - Koller, Kristen A
AU  - Koller KA
AD  - Division of Gastroenterology and Hepatology, Department of Medicine, Johns 
      Hopkins Medicine, Baltimore, Maryland, USA.
FAU - Haber, Gregory B
AU  - Haber GB
AD  - Division of Gastroenterology & Hepatology, Department of Medicine, New York 
      University Langone Health, New York, New York, USA.
LA  - eng
PT  - Journal Article
PT  - Video-Audio Media
DEP - 20210213
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2021 Oct;94(4):874-875. PMID: 34530976
MH  - *Adenoma/surgery
MH  - *Endoscopic Mucosal Resection/adverse effects
MH  - Endoscopy
MH  - Humans
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2021/02/17 06:00
MHDA- 2021/08/11 06:00
CRDT- 2021/02/16 20:09
PHST- 2020/10/05 00:00 [received]
PHST- 2021/02/06 00:00 [accepted]
PHST- 2021/02/17 06:00 [pubmed]
PHST- 2021/08/11 06:00 [medline]
PHST- 2021/02/16 20:09 [entrez]
AID - S0016-5107(21)00130-9 [pii]
AID - 10.1016/j.gie.2021.02.009 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2021 Aug;94(2):358-367.e1. doi: 10.1016/j.gie.2021.02.009. 
      Epub 2021 Feb 13.