Endoscopic full-thickness resection

Endoscopic full-thickness resection (EFTR) is the cutting edge of therapeutic endoscopy. It is a minimally invasive method designed to remove gastrointestinal subepithelial tumors originating from the muscularis propria. In this review we will focus on pure EFTR, a technique that evolved from endoscopic submucosal dissection and utilizes endoscopic submucosal dissection skills and equipment. Pure EFTR differs from device-assisted or laparoscopy-assisted EFTR. It has fewer limitations in terms of tumor location and size and is a true embodiment of the natural orifice transluminal endoscopic surgery concept. Here we will review the development, applications, equipment, technique, and outcomes of pure EFTR, as well as give a brief overview of the current state of the art featuring both the worldwide literature and data from our large referral center.