Colorectal endoscopic full-thickness resection: Initial experience from a tertiary centre in Singapore

Background/Aims

Colorectal endoscopic full-thickness resection using the full-thickness resection device is an emerging endoscopic therapy for non-lifting adenomas and subepithelial lesions. We aim to describe our initial experience and examine the outcomes of colorectal endoscopic full-thickness resection in our centre.

Methods

All colorectal endoscopic full-thickness resection performed from 2016 to 2021 were reviewed retrospectively. Demographic data, indication of endoscopic full-thickness resection, lesion size and location were collected. Outcomes assessed included technical success, complete resection, adverse events and need for surgery.

Results

Thirteen patients were included in the study. Four patients had recurrent/ residual adenoma and nine had rectal neuroendocrine tumours (NETs). The resected specimens measured 20-mm. Mean lesion size was 9.77 mm. All but one lesions were located in rectum. Technical success and complete resection rates were 100%. One patient underwent right hemicolectomy for unsuspected T1 adenocarcinoma with deep submucosal invasion. Four patients had minor post-procedure bleeding. No major adverse events were identified.

Conclusions

Colorectal endoscopic full-thickness resection with full-thickness resection device for treatment of residual/recurrent colorectal adenoma and rectal NET is efficacious and safe. It had a significant positive impact on management as it could definitively establish the adequacy of endoscopic resection by histology and confirm the feasibility of curative resection.