Gastroenterologie
a hepatologie

Full-thickness endoscopic resection of local residual neoplasia in the hepatic flexure – video case report

Přemysl Falt ^{Orcid.org  1}, Ondřej Urban ^{Orcid.org  2,3}, Martin Hanousek ^{Orcid.org  4}, Romana Andělová⁵

+ Affiliation
¹ II. interní klinika – gastroenterologická a geriatrická, LF UP a FN Olomouc
² II. interní klinika – gastroenterologie a geriatrie LF UP a FN Olomouc
³ Katedra interních oborů, LF UK v Hradci Králové
⁴ Centrum péče o zažívací trakt, Vítkovická nemocnice a. s., Ostrava
⁵ Komplexní onkologické centrum Nový Jičín

Summary

Full-thickness resection (FTR) is a new endoscopic technique enabling transmural resection of the large intestine via a combination of over-the-scope clip application and cap-assisted endoscopic mucosal resection. In fact, there is an intended perforation closed by the clip before the resection. According to existing but limited evidence, FTR is a feasible and safe alternative to endoscopic submucosal dissection or surgical resection of local residual neoplasia, early colorectal neoplasia with suspected submucosal invasion/fibrosis, and neuroendocrine tumors. We present a case of a 56-year-old patient after low anterior resection for rectal carcinoma and with local residual neoplasia after endoscopic mucosal resection in the hepatic flexure. The lesion was resected using the endoscopic FTR technique. Histological examination confirmed a completely resected tubular adenoma with high-grade intraepithelial neoplasia. The patient was dismissed after two days without any complications.

Keywords

colorectal cancer, local residual neoplasia, full-thickness resection

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Literature

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3. Schmidt A, Meining A, Birk M et al. Endoscopic full-thickness resection in the colorectum using an over-the-scope device – interim results of a prospective multicenter study. Gastrointest Endosc 2016; 83 (Suppl 5): AB119.