ASGE DDW Videos from Around the World | 2025-HYBRID ENDOSCOPIC SUBMUCOSAL DISSECTION AND ENDOSCOPIC FULL THICKNESS RESECTION FOR R0 RESECTION OF T1 COLONIC ADENOCARCINOMA

HYBRID ENDOSCOPIC SUBMUCOSAL DISSECTION AND ENDOSCOPIC FULL THICKNESS RESECTION FOR R0 RESECTION OF T1 COLONIC ADENOCARCINOMA

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Video Summary

The hybrid endoscopic submucosal dissection (ESD) and endoscopic full thickness resection (EFTR) technique is used for R0 resection of superficially invasive T1 colonic adenocarcinoma. EFTR involves pulling the lesion into a cap with grasping forceps, deploying a clip, and using electrocautery for resection, suitable for lesions up to 20 mm. ESD can make larger lesions pliable for EFTR. A case involving a 72-year-old man demonstrated this technique's effectiveness for a 35 mm polyp. Post-resection findings showed moderately differentiated adenocarcinoma with low tumor budding, prompting a referral to surgery due to high-risk pathological features.

Asset Subtitle

Rahul Karna

Keywords

endoscopic submucosal dissection

endoscopic full thickness resection

colonic adenocarcinoma

R0 resection

tumor budding