Multistaged endoscopic full-thickness resection using full-thickness resection device for large recurrent polyp: a case report

TL;DR

A new endoscopic technique is used to safely remove a large, recurring polyp in a difficult location.

Contribution

Demonstrates the safety and effectiveness of multistaged EFTR for large recurrent polyps in challenging anatomical locations.

Findings

A 60-mm recurrent polyp was successfully removed using three staged EFTR procedures.

Multistaged EFTR using the FTRD proved effective for large and fibrotic polyps in anatomically difficult locations.

The technique offers an alternative for polyps not amenable to conventional resection methods.

Abstract

Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD) (Ovesco Endoscopy AG, Tübingen, Germany) is an endoscopic technique for management of recurrent polyps up to 30 mm in size. However, data are currently limited on the use of multistaged piecemeal EFTR using the FTRD for larger recurrent and fibrotic polyps. Herein, we present the case of an 85-year-old man referred to advanced endoscopy for a 60-mm recurrent polyp adjacent to the ileocecal valve. The decision was made to perform piecemeal EFTR using the FTRD in a multistaged fashion because of its large size, technically challenging location, and multiple recurrences despite use of different resection modalities. A total of 3 colonoscopies with EFTR using the FTRD were performed with successful removal of the recurrent polyp. Our case report demonstrates that multistaged EFTR using the FTRD can be safe and effective for large polyps in anatomically difficult locations not amenable to conventional resection modalities.

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