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

• Humans
• Gastrointestinal Neoplasms/surgery
• Gastrointestinal Neoplasms/pathology
• Treatment Outcome
• Endoscopic Mucosal Resection/methods
• Laparoscopy/adverse effects
• Laparoscopy/methods
• Endoscopy, Gastrointestinal/methods

• EFTR
• endoscopic
• full-thickness resection
• meta-analysis

• Humans
• Male
• Female
• Endoscopic Mucosal Resection/methods
• Colon/pathology
• Treatment Outcome
• Rectum/surgery
• Rectum/pathology
• Adenoma/surgery
• Retrospective Studies

• Endoscopic resection (ESD, EMRc, ...)
• Endoscopy Lower GI Tract
• Endoscopy Upper GI Tract
• GI Pathology
• Polyps/adenomas/...
• Tissue diagnosis

• Humans
• Appendicitis
• Treatment Outcome
• Retrospective Studies
• Endoscopy
• Endoscopic Mucosal Resection/methods
• Colorectal Neoplasms/surgery
• Colorectal Neoplasms/pathology

• Colonic lesions
• Colonoscopy
• Endoscopic full-thickness resection
• Endoscopic resection
• Therapeutic endoscopy

Colonoscopy represents the most widespread and effective tool for the prevention and treatment of early stage preneoplastic and neoplastic lesions in the panorama of cancer screening. In the world there are different approaches to the topic of colorectal cancer prevention and screening: different starting ages (45-50 years); different initial screening tools such as fecal occult blood with immunohistochemical or immune-enzymatic tests; recto-sigmoidoscopy; and colonoscopy. The key aspects of this scenario are composed of a proper bowel preparation that ensures a valid diagnostic examination, experienced endoscopist in detection of preneoplastic and early neoplastic lesions and open-minded to upcoming artificial intelligence-aided examination, knowledge in the field of resection of these lesions (from cold-snaring, through endoscopic mucosal resection and endoscopic submucosal dissection, up to advanced tools), and management of complications.

• Colorectal lesions
• Colorectal tumor
• Endoscopic submucosal dissection
• Endoscopic mucosal resection
• Cold-endoscopic mucosal resection
• FTRD^®
• Complications
• Adverse events
• Polypectomy

The majority of colon lesions are <10 mm in size and are easily resected by endoscopists with appropriate basic training. Lesions ≥10 mm in size are difficult to remove technically and are associated with higher rates of incomplete resection. Currently, the main endoscopic approaches include endoscopic mucosal resection (EMR) for lesions without submucosal invasion, and endoscopic submucosal dissection (ESD) for relatively larger lesions involving the superficial submucosal layer. Both of these approaches have limitations, EMR cannot reliably ensure complete resection for larger tumors and recurrence is a key limitation. ESD reliably provides complete resection and an accurate pathological diagnosis but is associated with risk such as perforation or bleeding. In addition, both EMR and ESD may be ineffective in treating subepithelial lesions that extend beyond the submucosa. Endoscopic full-thickness resection (EFTR) is an emerging innovative endoscopic therapy which was developed to overcome the limitations of EMR and ESD. Advantages include enabling a transmural resection, complete resection of complex colorectal lesions involving the mucosa to the muscularis propria. Recent studies comparing EFTR with current resection techniques and radical surgery for relatively complicated and larger lesion have provided promising results. If the current trajectory of research and development is maintained, EFTR will likely to become a strong contender as an alternative standard of care for advanced colonic lesions. In the current study we aimed to address this need, and highlighted the areas of future research, while stressing the need for multinational collaboration provide the steppingstone(s) needed to bring EFTR to the mainstream.

• EFTR, endoscopic full-thickness resection
• ESD, endoscopic submucosal dissection
• FTRD, full-thickness resection device

• Ablation
• EMR
• ESD
• Gastrointestinal neuroendocrine tumors

• Colon
• EFTR
• FTRD
• endoscopic
• malignant

The studies on solitary gastric neurofibroma (GN) consist of only individual case reports, with little data and relevant information. We aimed to summarize the clinical features, endoscopic features, imaging findings, and pathological features and study the safety and efficacy of endoscopic treatment of solitary GN.

We retrospectively collected and analyzed clinical data of patients who underwent endoscopic treatment in Department of Gastroenterology of a well-known tertiary hospital from August 2007 to September 2019 and were accurately diagnosed as having solitary GN.

A total of 788 patients with gastric submucosal tumors underwent endoscopic treatment, among whom 11 patients were found to have solitary GNs. The incidence of solitary GNs was 1.4%. All 11 patients were treated with endoscopy. Five patients underwent endoscopic full-thickness resection (EFTR) and six patients underwent endoscopic submucosal excavation (ESE). The en bloc resection rate of the 11 lesions was 100.0%. The median endoscopic operation time was 80 minutes. Average length of hospital stay was 6.4 ± 1.6 days. The median follow-up time was 29 months. No recurrence, distant metastasis, or disease-related death occurred during the follow-up.

EFTR and ESE can serve as feasible, safe, and effective treatments for solitary GN.

• endoscopic full-thickness resection
• endoscopic submucosal excavation
• gastric
• neurofibroma
• solitary

Polyps are precursors to colorectal cancer, the third most common cancer in the United States. Large polyps, i.e.,, those with a size ≥ 20 mm, are more likely to harbor cancer. Colonic polyps can be removed through various techniques, with the goal to completely resect and prevent colorectal cancer; however, the management of large polyps can be relatively complex and challenging. Such polyps are generally more difficult to remove en bloc with conventional methods, and depending on level of expertise, may consequently be resected piecemeal, leading to an increased rate of incomplete removal and thus polyp recurrence. To effectively manage large polyps, endoscopists should be able to: (1) Evaluate the polyp for characteristics which predict high difficulty of resection or incomplete removal; (2) Determine the optimal resection technique (e.g., snare polypectomy, endoscopic mucosal resection, endoscopic submucosal dissection, etc.); and (3) Recognize when to refer to colleagues with greater expertise. This review covers important considerations in this regard for referring and receiving endoscopists and methods to best manage large colonic polyps.

• Adenoma
• Endoscopic mucosal resection
• Endoscopic tattoo
• Colorectal cancer
• Polypectomy

• Early rectal cancer
• Transanal endoscopic microsurgery
• Transanal endoscopic operation
• Transanal minimally invasive surgery

• Endoscopic full-thickness resection (eFTR)
• Endoscopic resection
• Full-thickness resection device (FTRD®)
• Polypectomy
• ‘WALL RESECT’

• Adenoma
• Aged
• Colonoscopy
• Female
• Hospitals
• Humans
• Male
• Retrospective Studies
• Treatment Outcome

• combined of endoscopic and laparoscopic surgery
• endoscopic full-thickness resection
• endoscopic submucosal dissection
• laparoscopy and endoscopy cooperative surgery

Endoscopic submucosal dissection to treat mucosal and submucosal lesions sometimes results in low rates of microscopically margin-negative (R0) resection. Endoscopic full-thickness resection (EFTR) has a high R0 resection rate and allows for the definitive diagnosis and treatment of selected mucosal and submucosal lesions that are not suitable for conventional resection techniques.

To evaluate the efficacy and safety of EFTR using an over-the-scope clip (OTSC).

This prospective, single-center, non-randomized clinical trial was conducted at the endoscopy center of Shengjing Hospital of China Medical University. The study included patients aged 18-70 years who had gastric or colorectal submucosal tumors (SMTs) (≤ 20 mm in diameter) originating from the muscularis propria based on endoscopic ultrasound (EUS) and patients who had early-stage gastric or colorectal cancer (≤ 20 mm in diameter) based on EUS and computed tomography. All lesions were treated by EFTR combined with an OTSC for wound closure between November 2014 and October 2016. We analyzed patient demographics, lesion features, histopathological diagnoses, R0 resection (negative margins) status, adverse events, and follow-up results.

A total of 68 patients (17 men and 51 women) with an average age of 52.0 ± 10.5 years (32-71 years) were enrolled in this study, which included 66 gastric or colorectal SMTs and 2 early-stage colorectal cancers. The mean tumor diameter was 12.6 ± 4.3 mm. The EFTR procedure was successful in all cases. The mean EFTR procedure time was 39.6 ± 38.0 min. The mean OTSC defect closure time was 5.0 ± 3.8 min, and the success rate of closure for defects was 100%. Histologically complete resection (R0) was achieved in 67 (98.5%) patients. Procedure-related adverse events were observed in 11 (16.2%) patients. The average post-procedure length of follow-up was 48.2 ± 15.7 mo. There was no recurrence during follow-up.

EFTR combined with an OTSC is an effective and safe technique for the removal of select subepithelial and epithelial lesions that are not amenable to conventional endoscopic resection techniques.

• Endoscopic full-thickness resection
• Over-the-scope clip
• Early gastric cancer
• Early colorectal cancer
• Submucosal tumor
• Gastrointestinal stromal tumor

• Adolescent
• Adult
• Aged
• China
• Endoscopic Mucosal Resection/adverse effects
• Endoscopy
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local
• Prospective Studies
• Retrospective Studies
• Stomach Neoplasms/diagnostic imaging
• Stomach Neoplasms/surgery
• Treatment Outcome
• Young Adult

• Duodenum
• Endoscopy
• Full-thickness resection
• Neuroendocrine tumour

Patient: Male, 77-year-old

Final Diagnosis: Enterocolic fistula

Symptoms: Diarrhea • pain and guarding of the abdomen • weight loss

Medication:—

Clinical Procedure: Colonoscopy with colon biopsy

Specialty: Gastroenterology and Hepatology