title: Endoscopic full-thickness resection and defect closure in the colon.
abstract: BACKGROUND
  Endoscopic full-thickness resection (eFTR) is a minimally invasive method for en bloc resection of GI lesions.
  
  
  OBJECTIVE
  The aim of this pilot study was to evaluate the feasibility of a grasp-and-snare technique for eFTR combined with an over-the-scope clip (OTSC) for defect closure.
  
  
  METHODS
  Nonsurvival animal study.
  
  
  METHODS
  Animal laboratory.
  
  
  METHODS
  Fourteen female domestic pigs.
  
  
  METHODS
  The eFTR was performed in porcine colons using a novel tissue anchor in combination with a standard monofilament snare and 14 mm OTSC. In the first group (n = 20), closure of the colonic defects with OTSC was attempted after the resection. In the second group (n = 8), an endoloop was used to secure the resection base before eFTR was performed.
  
  
  RESULTS
  In the first group (n = 20), eFTR specimens ranged from 2.4 to 5.5 cm in diameter. Successful closure was achieved in 9 out of 20 cases. Mean burst pressure for OTSC closure was 29.2 mm Hg (range, 2-90; SD, 29.92). Injury to adjacent organs occurred in 3 cases. Lumen obstruction due to the OTSC closure occurred in 3 cases. In the second group (n = 8), the diameter of specimens ranged from 1.2 to 2.2 cm. Complete closure was achieved in all cases, with a mean burst pressure of 76.6 mm Hg (range, 35-120; SD, 31). Lumen obstruction due to the endoloop closure occurred in one case. No other complications or injuries were observed in the second group.
  
  
  CONCLUSIONS
  Nonsurvival setting.
  
  
  CONCLUSIONS
  Colonic eFTR using the grasp-and-snare technique is feasible in an animal model. Ligation of the resection base with an endoloop before eFTR seems to reduce complication rates and improve closure success and leak test results despite yielding smaller specimens.
authors.affiliation: Department of Gastroenterology, Medizinische Klinik I, Klinikum Ludwigsburg, 71640 Ludwigsburg, Germany. renteln@gmx.net
authors.forename: Daniel
authors.initials: D
authors.lastname: von Renteln
authors.forename: Arthur
authors.initials: A
authors.lastname: Schmidt
authors.forename: Melina C
authors.initials: MC
authors.lastname: Vassiliou
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Rudolph
authors.forename: Karel
authors.initials: K
authors.lastname: Caca
mesh_terms: D000818:Animals; D003082:Colectomy / Q000379:methods*; D003108:Colonic Diseases / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D004195:Disease Models, Animal; D004210:Dissection / Q000379:methods; D005260:Female; D007413:Intestinal Mucosa / Q000601:surgery*; D010865:Pilot Projects; D015203:Reproducibility of Results; D013536:Suture Techniques / Q000295:instrumentation*; D013552:Swine