International Session(Workshop)3(JGES・JSGE・JSGS・JSGCS)
Sat. November 4th   14:00 - 16:30   Room 11: Portopia Hotel South Wing Topaz
The Utility of Hybrid-EFTR in Large Early Colorectal Neoplasia with Non-Lifting Component
Shiaw-Hooi Ho
Department of Medicine, Faculty of Medicine, University Malaya
Due to fibrosis or submucosal invasion, certain colorectal lesions could not be lifted adequately following submucosal injection. The utility of EMR or ESD in resecting such lesions remains a challenge even in the hands of the experts.(Inada et al., 2013)
With the introduction of over-the-scope-clip which allow full thickness plication of the luminal wall before resection, endoscopic full thickness resection (EFTR) was made safer. Hybrid EFTR is a technique of combining piecemeal EMR (p-EMR) with EFTR in resecting larger colorectal lesions with a small focus of non-lifting component. In this technique, p-EMR was first performed to resect the portion of the lesion with good lifting and isolate the portion with poor lifting. The portion with poor lifting is ultimately resected by EFTR technique. Studies, mainly case series at the present stage, revealed high technical success rate with good safety profile and long-term efficacy.(Chua et al., 2021; Mahadev et al., 2021; Meier, Elsayed, Seitz, Wannhoff, & Caca, 2023)
Hybrid EFTR can be considered in certain large colorectal lesion with non-lifting signs provided that there is no invasive pattern or features. In certain centres where ESD service is not available and/or patients who do not wish to have surgery, hybrid EFTR may also be considered provided that the patients understand and accept the the risk of such resection.
Index Term 1: Hybrid Endoscopic Full Thickness Resection
Index Term 2: Non-Lifting
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