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Endoscopic Full-Thickness Resection of Polyps Involving the Appendiceal Orifice: A Multicenter International Experience. Endoscopy Ichkhanian, Y. n., Barawi, M. n., Thakkar, S. J., Seoud, T. n., Kothari, T. H., Halabi, M. E., Ullah, A. n., Edris, W. n., Aepli, P. n., Kowalski, T. E., Shinn, B. n., Sharaiha, R. Z., Mahadev, S. n., Mosko, J. D., Andrisani, G. n., Di Matteo, F. M., Albrecht, H. n., Giap, A. n., Tang, S. J., van Geenen, E. M., Friedland, S. n., Tharian, B. n., Irani, S. n., Ross, A. n., Jamil, L. H., Lew, D. n., Nett, A. n., Farha, J. n., Runge, T. M., Jovani, M. n., Khashab, M. A. 2021

Abstract

Endoscopic resection of lesions involving the appendiceal orifice (AO) remains a challenge. We aim to report the outcomes of full-thickness resection device (FTRD) for the resection of appendiceal lesions and identify factors associated with the occurrence of appendicitis.This is a retrospective study at 18 tertiary-care centers (12 U.S., Canada 1, 5 Europe) between 11/2016 and 8/2020. Consecutive patients who underwent resection of AO lesions using the FTRD were included. The primary outcome was the rate of R0 margin resection in neoplastic lesions, defined as negative lateral and deep margins on post-resection histologic evaluation. Secondary outcomes included the rates of; technical success (en bloc resection), clinical success (technical success without need for further surgical interventions), post-resection appendicitis, and polyp recurrence.A total of 66 patients (mean age 64 yr., 29 F) underwent resection of colonic lesions (mean size 14.5 (6.2) mm) involving the AO, with 40 (61%) deep extending into the appendiceal lumen. Technical success was achieved in 59/66 (89%) cases, out of which, 56 were found to be neoplastic lesions on post-resection pathology. Clinical success was achieved in 53/66 (80%). R0 resection was achieved in 52/56 (93%) cases. Out of the 58 patients of whom EFTR was completed and had no prior history of appendectomy, appendicitis was reported in 10 (17%) cases, with 6 (60%) requiring surgical appendectomies. Follow-up colonoscopy was completed in 41 cases with evidence of recurrence in 5 (12.2%).FTRD is a promising non-surgical alternative for resecting appendiceal lesions but appendicitis occurs in 1 out of 6 cases.

View details for DOI 10.1055/a-1345-0044

View details for PubMedID 33395714