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Therapeutic Endoscopy · Journal article
Den Open · July 3, 2026
Encouraging direction, but not yet definitive.
This multicenter retrospective cohort demonstrates that colorectal endoscopic full-thickness resection using FTRD achieves technical success in 89% of 170 procedures with an R0 resection rate of 79%, but early and delayed adverse events occur in 4.1% and 12.9% respectively. Female sex and appendiceal orifice lesions were independently associated with adverse events, and appendicitis developed in 17% of appendiceal orifice procedures; however, the short median follow-up of 5 months and retrospective design limit the strength of conclusions about long-term recurrence and durability.
Multicenter retrospective cohort study. Consecutive adult patients (≥18 years) undergoing colorectal EFTR with FTRD for lesions ≥30 mm not amenable to conventional endoscopic resection (primary non-lifting, secondary non-lifting, appendiceal orifice or diverticular lesions, suspected T1 adenocarcinoma, subepithelial lesions, positive mar…. Intervention: Endoscopic full-thickness resection using the full-thickness resection device (FTRD; Ovesco Endoscopy, Tübingen, Germany), a nonexposed EFTR technique deploying a full-thickness clip prior to snare resection with immediate defect closure.. n = 170. 13 centers in Australia and New Zealand.
Technical success achieved in 89% of 170 EFTR procedures (mean age 67 years, 57% male) R0 resection rate of 79% overall; adenocarcinoma confirmed in 23% of lesions on histopathology Early adverse events in 4.1% (n=170) and delayed adverse events in 12.9%, including post-procedural bleeding (n=11), perforation (n=5), and post-polypectomy syndrome (n=2)
Source text truncated; full methods, additional subgroup analyses, and detailed discussion of adverse event predictors may not be fully represented. Early adverse events in 4.1% (n=170) and delayed adverse events in 12.9%, including post-procedural bleeding (n=11), perforation (n=5), and post-polypectomy syndrome (n=2)
EFTR with FTRD appears effective for resection of complex colorectal lesions with acceptable safety in an Australasian cohort; however, the short median follow-up (5 months) means recurrence and long-term durability remain poorly characterized. Clinicians should note the elevated risk of appendicitis (17%) in appendiceal orifice lesions and of adverse events in female patients, warranting careful patient selection and informed consent discussion.
A multicenter retrospective cohort of 170 procedures with clear technical success, R0 resection, and safety outcomes, but limited by retrospective design, short median follow-up (5 months), and lack of a comparator group.
As stated by the source record.
Quoted from the source exactly as published.
EFTR with FTRD appears effective for resection of complex colorectal lesions with acceptable safety in an Australasian cohort; however, the short median follow-up (5 months) means recurrence and long-term durability remain poorly characterized. Clinicians should note the elevated risk of appendicitis (17%) in appendiceal orifice lesions and of adverse events in female patients, warranting careful patient selection and informed consent discussion.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background. Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD) is an emerging technique for the management of complex colorectal lesions and early colorectal cancers. Although EFTR offers a minimally invasive alternative to surgery, data on efficacy, safety, and predictors of adverse events (AEs) remain limited. This study evaluated outcomes of colorectal EFTR using FTRD and identified patient- and lesion-related factors associated with AEs.Methods. This multicenter retrospective study included patients who underwent colorectal EFTR with FTRD across 13 centers in Australia and New Zealand. Patient demographics, lesion characteristics, procedural outcomes, R0 resection rates, and AEs were analyzed.Results. A total of 170 EFTR procedures were performed. The mean patient age was 67 years (standard deviation [SD] 13.7), and 57% were male. Mean procedure time was 51 min (SD 28.5). The most common indication was non-lifting lesions (36%). Technical success was achieved in 89% of cases. Adenocarcinoma was confirmed on histopathology in 23% of lesions, with an R0 resection rate of 79%. Recurrence occurred in 7.4% of cases during a median follow-up of 5 months (interquartile range [IQR] 8.5). Early and delayed AEs occurred in 4.1% and 12.9%, respectively, including post-procedural bleeding (n = 11), perforation (n = 5), and post-polypectomy syndrome (n = 2). Among 41 procedures involving appendiceal orifice lesions, appendicitis developed in 17% (n = 7). AEs were significantly associated with female sex (64% vs. 40%, p = 0.03) and appendiceal orifice lesions (46% vs. 21%, p = 0.02).Conclusion. Colorectal EFTR using FTRD is effective for the resection of complex colorectal lesions. Careful patient selection and risk stratification are essential to optimize outcomes.
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