Real-world topographical efficacy, procedural outcome and safety of endoscopic full thickness resection in colon segments

Table 1 Descriptive characteristics of the analysis population (n = 102), n (%)¹

Parameter
Age	70 (64-78)
Duration of EFTR (minute)	99 (88-115)
Gender
Male	64 (62.7)
Female	38 (37.3)
Location of lesion
Cecum	12 (11.8)
Ascending colon	25 (24.5)
Transverse colon	15 (14.7)
Descending colon	13 (12.7)
Sigmoid colon	17 (16.7)
Rectum	20 (19.6)
Lesion size (n = 102)
Length (mm)	20 (15-25)
Width (mm)	19 (13-24)
Depth (mm)	3 (3-4)
Histologically complete resection	81 (79.4)
Microscopic residual resection	21 (20.6)
Number of patients with ≥ 1 AEs to EFTR	33 (32.4)
Minor AEs to EFTR	44 (43.1)
Major AEs to EFTR	1 (0.98)
Section-specific frequencies of AE to EFTR in the analysis population (≥ 1 AE)
Cecum	5/12 (41.7)
Ascending colon	10/25 (40.0)
Transverse colon	12/15 (80.0)
Descending colon	8/13 (61.5)
Sigmoid colon	8/17 (47.1)
Rectum	2/20 (10.0)

¹Results for interval and ratio data are presented as median (interquartile range), nominal data are presented as absolute and relative frequencies, n (%).

AE: Adverse events; EFTR: Endoscopic full thickness resection.

Table 2 Categorized histology for lesions treated with endoscopic full thickness resection (n = 102)

	Frequency (n)	Pro-tion (%)	Low grade IEN (n)	Low grade IEN (%)	High grade IEN (n)	High grade IEN (%)
Tubular adenoma	32	31.4	22	68.7	10	31.3
Tubulovillous adenoma	29	28.4	15	51.7	14	48.3
Adenocarcinoma	13	12.7	0	0	13	100
Sessile serrated adenoma	9	8.8	5	55.6	3	33.3
Neuroendocrine tumor	6	5.9	0	0	0	0
Villous adenoma	2	1.8	2	100	0	0
Mucinous adenocarcinoma	1	0.98	0	0	1	100
Other (malignant melanoma, lymphofollicular hyperplasia amyloidosis, etc.)	10	9.8	-	-	-	-

IEN: Intraepithelial neoplasia.

Table 3 Distribution of histologically complete resection and microscopic residual resection per section of the large intestine, n (%)

Section	R0	R1
Cecum (n = 12)	10 (83.3)	2 (16.7)
Ascending colon (n = 25)	21 (84.0)	4 (16.0)
Transverse colon (n = 15)	11 (73.3)	4 (26.7)
Descending colon (n = 13)	11 (84.6)	2 (15.4)
Sigmoid colon (n = 17)	13 (76.5)	4 (23.5)
Rectum (n = 20)	17 (85.0)	3 (15.0)
Total (n = 102)	83 (81.4)	19 (18.6)

R0: Histologically complete resection; R1: Microscopic residual resection.

Table 4 Generalized linear model using logistic regression for histologically complete resection outcome

	Estimate	SE	P value	OR	OR (95%CI low)	OR (95%CI high)
Intercept	2.52	2.34	0.28	-	-	-
Age	-0.01	0.03	0.61	0.99	0.93	1.04
Gender	-0.96	0.52	0.07	0.38	0.14	1.06
Lesion length (mm)	-0.03	0.04	0.48	0.97	0.89	1.05
Lesion depth (mm)	0.01	0.17	0.93	1.01	0.74	1.45
EFTR duration (minutes)	0.00	0.01	0.86	1.00	0.99	1.02
Ascending colon vs reference1	0.39	0.76	0.61	1.47	0.32	6.59
Descending colon vs reference1	0.36	0.91	0.69	1.43	0.24	9.29
Cecum vs reference1	0.89	0.99	0.36	2.44	0.38	21.25
Sigmoid colon vs reference1	0.03	0.82	0.97	1.03	0.20	5.26
Rectum vs reference1	1.42	1.02	0.17	4.12	0.60	37.81

¹Reference (as determined by dummy coding): Transverse colon.

EFTR: Endoscopic full thickness resection; SE: Standard error of the estimate.

Table 5 Frequency of adverse events related to endoscopic full thickness resection, n (%)

Location	Hematochezia	Fever	Post-interventional abdominal pain	Hemoglobin decline	Severe adverse events (any)	Total no. of AE/pts with AE, (%)
Cecum (n = 12)	1 (8.3)	2 (16.6)	1 (8.3)	1 (8.3)	-	5/4 (33.3)
Ascending colon (n = 25)	2 (8.0)	-	5 (20.0)	3 (12.0)	-	10/8 (32.0)
Transverse colon (n = 15)	4 (26.7)	2 (13.3)	5 (33.3)	1 (6.7)	-	12/8 (53.3)
Descending colon (n = 13)	1 (7.7)	1 (7.7)	4 (30.8)	2 (15.4)	-	8/5 (38.5)
Sigmoid colon (n = 17)	2 (11.8)	2 (11.8)	3 (17.7)	-	1 (5.9)1	8/6 (35.3)
Rectum (n = 20)	-	-	1 (5.0)	1 (5.0)	-	2/2 (10.0)
Total (n = 102) (across segments)	10 (9.8)	7 (6.9)	19 (18.6)	8 (7.8)	1 (0.98)	45/33 (32.4)

¹Perforation of sigmoid colon with immediate emergency surgery.

This table shows the distribution of adverse events (AE) related to endoscopic full thickness resection by section of the large intestine. Blank table cells reflect absence of AEs occurring in the respective section. Percentages for AEs are given with respect to the underlying number of patients with lesions in the corresponding section (see first column in each line). Total proportions across segments refer to the proportions of patients with the corresponding AE in the analysis population (n = 102).