{
  "abstract": "Introduction Traditionally the management of polyp recurrence, submucosal lesions, early T1 cancer and non-lifting adenomas have required either endoscopic submucosal resection or surgical options, and the preserve of tertiary institutions. 1 Since described in 2015, endoscopic full thickness resection presents an attractive endoscopic option for managing these lesions.2 3 We present our district general hospital’s experience and implementation into this useful adjunct into management of these lesions.Methods Data was collected from patients who had an endoscopic full thickness resection between November 2023 to November 2024. Outcome measures included technical success/complications, R0 resection, procedural time, lesion size and adverse events. All procedures were performed by 2 endoscopists who received in vivo training prior.Results Across this period, 10 patients were identified, with a mean age of 70 years. Indications for eFTRD included T1 colorectal adenocarcinoma (2), caecal/appendiceal polyps (3 hybrid eFTRD/EMR ) polyp recurrence (2), submucosal lesions (2) and flat non lifting gastric adenoma (1).All lesions were reached with the eFTRD device, and all procedures were technically successful. 60% (6/10) were performed on deep sedation lists with anaesthetic support, and the remainder under normal conscious sedation. Median procedure time was 97 mins (IQR 38- 163) The mean size of specimen was 18.4mm.There were no intraprocedural complications. There were no adverse events post procedure including perforation or delayed bleeding. 80% (8/10) procedures achieved R0 resection. Amongst the two R1 resections, 1 has shown no evidence of recurrence at repeat endoscopy 9 months later (well differentiated NET).Conclusions Our case series suggests eftrd may provide a safe and effective way of dealing with challenging endoscopic lesions, achieving good R0 resection rates within an acceptable procedural time. The learning curve for this procedure appears relatively straightforward in comparison to ESD, and is feasible within the setting of a district general hospital. 4References Hu M, Rahman I, Ishaq S, et al. ADTH-01 endoscopic full thickness resection in the colon: 3-year multicentre UK experience. Gut 2018;67:A7.Ferlitsch, Monika, et al. Colorectal polypectomy and endoscopic mucosal resection: European society of gastrointestinal endoscopy (ESGE) guideline - update 2024. Endoscopy 2024;56(7):516–545. doi:10.1055/a-2304-3219Dolan, Russell D, et al. Endoscopic full-thickness resection of colorectal lesions: a systematic review and meta-analysis. Gastrointestinal Endoscopy 2022:95(2):216–224.e18. doi:10.1016/j.gie.2021.09.039McKechnie, Tyler, et al. Endoscopic full-thickness resection for colorectal lesions: a systematic review and meta-analysis. The Journal of Surgical Research 2022;280:440–449. doi:10.1016/j.jss.2022.07.019",
  "authors": [
    {
      "affiliations": [
        "Barking, Havering, and Redbridge University Trust, United Kingdom"
      ],
      "name": "Severine Matthews"
    },
    {
      "affiliations": [
        "Barking, Havering, and Redbridge University Trust, United Kingdom"
      ],
      "name": "Tanaya Gandhi"
    },
    {
      "affiliations": [
        "Barking, Havering, and Redbridge University Trust, United Kingdom"
      ],
      "name": "Vinoth Nadesalingam"
    },
    {
      "affiliations": [
        "Barking, Havering, and Redbridge University Trust, United Kingdom"
      ],
      "name": "Abhinav Gupta"
    },
    {
      "affiliations": [
        "Barking, Havering, and Redbridge University Trust, United Kingdom"
      ],
      "name": "Sergio Coda"
    }
  ],
  "title": "P45 Thick cut: adoption of endoscopic full thickness resection for challenging lesions",
  "uid": "92a1b95f-0b87-5713-9609-8d617ae807a0"
}