Endoscopic full thickness resection: techniques, applications, outcomes

ABSTRACT

Introduction

Endoscopic full-thickness resection (EFTR) represents a pivotal advancement in the minimally invasive treatment of gastrointestinal lesions, offering a novel approach for the management of lesions previously deemed challenging or unreachable through conventional endoscopic techniques.

Areas Covered

This review discusses the development, methodologies, applications, and clinical outcomes associated with EFTR, including exposed and device-assisted EFTR, the integration of endoscopic mucosal resection with EFTR in hybrid techniques, and the collaborative approach between laparoscopic and endoscopic surgery (LECS). It encapsulates a comprehensive analysis of the various EFTR techniques tailored to specific lesion characteristics and anatomical locations, underscoring the significance of technique selection based on the lesion’s nature and situational context.

Expert Opinion/Commentary

The review underscores EFTR’s transformative role in expanding therapeutic horizons for gastrointestinal tumors, emphasizing the importance of technique selection tailored to the unique attributes of each lesion. It highlights EFTR’s capacity to facilitate organ-preserving interventions, thereby significantly enhancing patient outcomes and reducing procedural complications. EFTR is a cornerstone in the evolution of gastrointestinal surgery, marking a significant leap forward in the pursuit of precision, safety, and efficacy in tumor management.

KEYWORDS:

• Endoscopy
• gastrointestinal; tumor resection
• endoscopic; surgical procedures
• minimally invasive; endoscopes
• gastrointestinal

Article highlights

• EFTR offers a novel and organ-preserving approach for managing difficult gastrointestinal lesions.

• It incorporates exposed and device-assisted EFTR techniques for precise resections.

• Hybrid approach combines endoscopic and laparoscopic methods for resection of lesions not amenable to either approach alone.

• The selection of EFTR technique is vital, based on lesion characteristics like size, location and proportion of intraluminal component.

• EFTR represents a significant advancement in gastrointestinal surgery and highlights the importance of integrating new technologies in clinical practice.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Zaheer Nabi contributed to the conception and design of the study, overseeing the literature review related to Endoscopic Full-Thickness Resection (EFTR) techniques. D. Nageshwar Reddy assisted in drafting the manuscript and revising it critically for important intellectual content, ensuring the accuracy and integrity of the work.

Additional information

Funding

This paper was not funded.