TBA (21W170)

The Use of Endoscopic Full Thickness Resection for Large and Recurrent Colorectal Polyps in the South Eastern Trust since 2018: A Potential Alternative to Surgical Resection.

Author(s)

S Davidson, P B Allen, A McBrearty, K McCallion

Department(s)/Institutions

General Surgery and Gastroenterology, Ulster Hospital, South Eastern Trust, Northern Ireland

Introduction

Surgical excision has been the mainstay of treatment for patients with complex colorectal polyps. Endoscopic full thickness resection (eFTR) offers an alternative treatment option for these patients.

Aims/Background

To review a case series of patients who have undergone eFTR for large or recurrent colorectal polyps. To assess patient demographics, outcomes, complications and follow up.

Method

A retrospective review of all patients who had eFTR in the South Eastern Trust since 2018. Data collected from Unisoft (endoscopy reporting system) and NI Electronic Care Record. Large polyps were defined as ≥ 20mm and recurrent as being previously incompletely excised using standard endoscopic techniques.

Results

Between October 2018-May 2021, 31 patients underwent eFTR. Of these, 13 were female (42%) and overall median age was 71(55-86). 21 polyps were recurrent and 10 polyps were ≥ 20mm. 94%(29/31) were discharged on the day of procedure with no significant immediate or delayed complications. 17 polyps were histologically malignant; 5 pT1 adenocarcinomas had R0 resections, 4 showed no residual tumour, 8 patients had incomplete excision with 6 proceeding to surgical resection. Excluding patients who proceeded to surgery, 88%(22/25) have had at least one surveillance endoscopy with a median wait time to initial surveillance of 89 days. Recurrence was identified in 4 patients, all were originally recurrent polyps and were successfully managed endoscopically.

Conclusions

Endoscopic Full Thickness Resection provides a safe and effective treatment option for patients with large and/or recurrent colorectal polyps enabling end-organ preservation and offering a potentially curative approach for patients deemed unsuitable for major surgical resection.