A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions

Y. Ichkhanian; K. Vosoughi; D. L. Diehl; I. S. Grimm; T. W. James; A. W. Templeton; K. Hajifathalian; J. L. Tokar; J. B. Samarasena; N. El Hage Chehade; J. Lee; K. Chang; M. Mizrahi; M. Barawi; S. Irani; S. Friedland; P. Korc; A. A. Aadam; M. A. Al-Haddad; T. E. Kowalski; A. Novikov; G. Smallfield; G. G. Ginsberg; V. M. Oza; D. Panuu; N. Fukami; H. Pohl; Michael Lajin; N. A. Kumta; S. J. Tang; Y. M. Naga; S. K. Amateau; G. O.I. Brewer; V. Kumbhari; R. Sharaiha; Mouen A. Khashab

doi:10.1007/s00464-020-07504-9

A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions

Y. Ichkhanian, K. Vosoughi, D. L. Diehl, I. S. Grimm, T. W. James, A. W. Templeton, K. Hajifathalian, J. L. Tokar, J. B. Samarasena, N. El Hage Chehade, J. Lee, K. Chang, M. Mizrahi, M. Barawi, S. Irani, S. Friedland, P. Korc, A. A. Aadam, M. A. Al-Haddad, T. E. KowalskiA. Novikov, G. Smallfield, G. G. Ginsberg, V. M. Oza, D. Panuu, N. Fukami, H. Pohl, Michael Lajin, N. A. Kumta, S. J. Tang, Y. M. Naga, S. K. Amateau, G. O.I. Brewer, V. Kumbhari, R. Sharaiha, Mouen A. Khashab

Medicine - Gastro, Hepatology, Nutrition Division

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.

Original language	English (US)
Pages (from-to)	1296-1306
Number of pages	11
Journal	Surgical endoscopy
Volume	35
Issue number	3
DOIs	https://doi.org/10.1007/s00464-020-07504-9
State	Published - Mar 2021

Bibliographical note

Funding Information:
Dr. Khashab is consultant for Boston Scientific, Medtronic, and Olympus. Dr. Ian Grimm is a consultant for Boston Scientific. Dr. Irani is a consultant for Boston Scientific. Dr. Kumbhari is a consultant for ReShape Life Sciences, Apollo Endosurgery, Medtronic, and Boston Scientific. Dr. Nikhil is a consultant for Apollo Endosurgery, Boston scientific, and Olympus. Dr. Amateau is a consultant for Merit Endoscopy, Boston Scientific, US Endoscopy, and Neurotronic and the recipient of research support from Cook Medical. Dr. Smallfield has research funding from CSA medical and C2 therapeutics. Dr. Aadam AA is a consultant for Boston Scientific. Dr. Diehl Md Consultant for Boston Scientific, Olympus, Pentax, Cook Medical, Merit, ConMed, US Endoscopy, Medtronic, Lumendi. Dr. Chang consultant for Apollo, Boston Scientific, Cook, Covidien, Erbe, Endogastric Solutions, Mauna Kea Mederi, Medtronic, Olympus, Ovesco, Pentax, Torax. Dr. Samarasena has educational grant from Cook and consultant for Mauna Kea, Medtronic, Olympus, Pentax, US Endoscopy. Dr. Al-Haddad received research and teaching support from Boston Scientific. Dr. Pohl received grants from Boston Scientific, US Endoscopy, and Aries/Cosmo Pharamceuticals. Dr. Templeton is a consultant for Boston Scientific and Medtronic. Dr. Ginsberg is a consultant for Olympus Inc. and Boston Scientific. Dr. Fukami is consultant for Boston Scientific and Olympus. Dr. Sharaiha is consultant for Boston Scientific, Olympus, Apollo, and Medtronic. Dr. Ichkhanian, Dr. Vosoughi, Dr. James, Dr. Hajifathalian, Dr. Tokar, Dr. Lee, Dr. Mizrahi, Dr. Barawi, Dr. Friedland, Dr. Korc, Dr. Kowalski, Dr. Novikov, Dr. Oza, Dr. Panuu, Dr. Lajin, Dr. Kumta, Dr. Tang, Dr. Naga, and Dr. Brewer have no conflicts of interest or financial ties to disclose

Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

Difficult adenomas
Endoscopic full-thickness resection
FTRD
Full-thickness resection device

PubMed: MeSH publication types

Journal Article
Multicenter Study

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00464-020-07504-9

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Ichkhanian, Y., Vosoughi, K., Diehl, D. L., Grimm, I. S., James, T. W., Templeton, A. W., Hajifathalian, K., Tokar, J. L., Samarasena, J. B., Chehade, N. E. H., Lee, J., Chang, K., Mizrahi, M., Barawi, M., Irani, S., Friedland, S., Korc, P., Aadam, A. A., Al-Haddad, M. A., ... Khashab, M. A. (2021). A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions. Surgical endoscopy, 35(3), 1296-1306. https://doi.org/10.1007/s00464-020-07504-9

Ichkhanian, Y, Vosoughi, K, Diehl, DL, Grimm, IS, James, TW, Templeton, AW, Hajifathalian, K, Tokar, JL, Samarasena, JB, Chehade, NEH, Lee, J, Chang, K, Mizrahi, M, Barawi, M, Irani, S, Friedland, S, Korc, P, Aadam, AA, Al-Haddad, MA, Kowalski, TE, Novikov, A, Smallfield, G, Ginsberg, GG, Oza, VM, Panuu, D, Fukami, N, Pohl, H, Lajin, M, Kumta, NA, Tang, SJ, Naga, YM, Amateau, SK, Brewer, GOI, Kumbhari, V, Sharaiha, R & Khashab, MA 2021, 'A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions', Surgical endoscopy, vol. 35, no. 3, pp. 1296-1306. https://doi.org/10.1007/s00464-020-07504-9

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title = "A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions",

abstract = "Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.",

keywords = "Difficult adenomas, Endoscopic full-thickness resection, FTRD, Full-thickness resection device",

author = "Y. Ichkhanian and K. Vosoughi and Diehl, {D. L.} and Grimm, {I. S.} and James, {T. W.} and Templeton, {A. W.} and K. Hajifathalian and Tokar, {J. L.} and Samarasena, {J. B.} and Chehade, {N. El Hage} and J. Lee and K. Chang and M. Mizrahi and M. Barawi and S. Irani and S. Friedland and P. Korc and Aadam, {A. A.} and Al-Haddad, {M. A.} and Kowalski, {T. E.} and A. Novikov and G. Smallfield and Ginsberg, {G. G.} and Oza, {V. M.} and D. Panuu and N. Fukami and H. Pohl and Michael Lajin and Kumta, {N. A.} and Tang, {S. J.} and Naga, {Y. M.} and Amateau, {S. K.} and Brewer, {G. O.I.} and V. Kumbhari and R. Sharaiha and Khashab, {Mouen A.}",

note = "Funding Information: Dr. Khashab is consultant for Boston Scientific, Medtronic, and Olympus. Dr. Ian Grimm is a consultant for Boston Scientific. Dr. Irani is a consultant for Boston Scientific. Dr. Kumbhari is a consultant for ReShape Life Sciences, Apollo Endosurgery, Medtronic, and Boston Scientific. Dr. Nikhil is a consultant for Apollo Endosurgery, Boston scientific, and Olympus. Dr. Amateau is a consultant for Merit Endoscopy, Boston Scientific, US Endoscopy, and Neurotronic and the recipient of research support from Cook Medical. Dr. Smallfield has research funding from CSA medical and C2 therapeutics. Dr. Aadam AA is a consultant for Boston Scientific. Dr. Diehl Md Consultant for Boston Scientific, Olympus, Pentax, Cook Medical, Merit, ConMed, US Endoscopy, Medtronic, Lumendi. Dr. Chang consultant for Apollo, Boston Scientific, Cook, Covidien, Erbe, Endogastric Solutions, Mauna Kea Mederi, Medtronic, Olympus, Ovesco, Pentax, Torax. Dr. Samarasena has educational grant from Cook and consultant for Mauna Kea, Medtronic, Olympus, Pentax, US Endoscopy. Dr. Al-Haddad received research and teaching support from Boston Scientific. Dr. Pohl received grants from Boston Scientific, US Endoscopy, and Aries/Cosmo Pharamceuticals. Dr. Templeton is a consultant for Boston Scientific and Medtronic. Dr. Ginsberg is a consultant for Olympus Inc. and Boston Scientific. Dr. Fukami is consultant for Boston Scientific and Olympus. Dr. Sharaiha is consultant for Boston Scientific, Olympus, Apollo, and Medtronic. Dr. Ichkhanian, Dr. Vosoughi, Dr. James, Dr. Hajifathalian, Dr. Tokar, Dr. Lee, Dr. Mizrahi, Dr. Barawi, Dr. Friedland, Dr. Korc, Dr. Kowalski, Dr. Novikov, Dr. Oza, Dr. Panuu, Dr. Lajin, Dr. Kumta, Dr. Tang, Dr. Naga, and Dr. Brewer have no conflicts of interest or financial ties to disclose Publisher Copyright: {\textcopyright} 2020, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2021",

month = mar,

doi = "10.1007/s00464-020-07504-9",

language = "English (US)",

volume = "35",

pages = "1296--1306",

journal = "Surgical endoscopy",

issn = "0930-2794",

publisher = "Springer New York",

number = "3",

}

TY - JOUR

T1 - A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions

AU - Ichkhanian, Y.

AU - Vosoughi, K.

AU - Diehl, D. L.

AU - Grimm, I. S.

AU - James, T. W.

AU - Templeton, A. W.

AU - Hajifathalian, K.

AU - Tokar, J. L.

AU - Samarasena, J. B.

AU - Chehade, N. El Hage

AU - Lee, J.

AU - Chang, K.

AU - Mizrahi, M.

AU - Barawi, M.

AU - Irani, S.

AU - Friedland, S.

AU - Korc, P.

AU - Aadam, A. A.

AU - Al-Haddad, M. A.

AU - Kowalski, T. E.

AU - Novikov, A.

AU - Smallfield, G.

AU - Ginsberg, G. G.

AU - Oza, V. M.

AU - Panuu, D.

AU - Fukami, N.

AU - Pohl, H.

AU - Lajin, Michael

AU - Kumta, N. A.

AU - Tang, S. J.

AU - Naga, Y. M.

AU - Amateau, S. K.

AU - Brewer, G. O.I.

AU - Kumbhari, V.

AU - Sharaiha, R.

AU - Khashab, Mouen A.

N1 - Funding Information: Dr. Khashab is consultant for Boston Scientific, Medtronic, and Olympus. Dr. Ian Grimm is a consultant for Boston Scientific. Dr. Irani is a consultant for Boston Scientific. Dr. Kumbhari is a consultant for ReShape Life Sciences, Apollo Endosurgery, Medtronic, and Boston Scientific. Dr. Nikhil is a consultant for Apollo Endosurgery, Boston scientific, and Olympus. Dr. Amateau is a consultant for Merit Endoscopy, Boston Scientific, US Endoscopy, and Neurotronic and the recipient of research support from Cook Medical. Dr. Smallfield has research funding from CSA medical and C2 therapeutics. Dr. Aadam AA is a consultant for Boston Scientific. Dr. Diehl Md Consultant for Boston Scientific, Olympus, Pentax, Cook Medical, Merit, ConMed, US Endoscopy, Medtronic, Lumendi. Dr. Chang consultant for Apollo, Boston Scientific, Cook, Covidien, Erbe, Endogastric Solutions, Mauna Kea Mederi, Medtronic, Olympus, Ovesco, Pentax, Torax. Dr. Samarasena has educational grant from Cook and consultant for Mauna Kea, Medtronic, Olympus, Pentax, US Endoscopy. Dr. Al-Haddad received research and teaching support from Boston Scientific. Dr. Pohl received grants from Boston Scientific, US Endoscopy, and Aries/Cosmo Pharamceuticals. Dr. Templeton is a consultant for Boston Scientific and Medtronic. Dr. Ginsberg is a consultant for Olympus Inc. and Boston Scientific. Dr. Fukami is consultant for Boston Scientific and Olympus. Dr. Sharaiha is consultant for Boston Scientific, Olympus, Apollo, and Medtronic. Dr. Ichkhanian, Dr. Vosoughi, Dr. James, Dr. Hajifathalian, Dr. Tokar, Dr. Lee, Dr. Mizrahi, Dr. Barawi, Dr. Friedland, Dr. Korc, Dr. Kowalski, Dr. Novikov, Dr. Oza, Dr. Panuu, Dr. Lajin, Dr. Kumta, Dr. Tang, Dr. Naga, and Dr. Brewer have no conflicts of interest or financial ties to disclose Publisher Copyright: © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

PY - 2021/3

Y1 - 2021/3

N2 - Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.

AB - Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions.

KW - Difficult adenomas

KW - Endoscopic full-thickness resection

KW - FTRD

KW - Full-thickness resection device

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UR - http://www.scopus.com/inward/citedby.url?scp=85081594200&partnerID=8YFLogxK

U2 - 10.1007/s00464-020-07504-9

DO - 10.1007/s00464-020-07504-9

M3 - Article

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AN - SCOPUS:85081594200

SN - 0930-2794

VL - 35

SP - 1296

EP - 1306

JO - Surgical endoscopy

JF - Surgical endoscopy

IS - 3

ER -

A large multicenter cohort on the use of full-thickness resection device for difficult colonic lesions

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

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