TREATING DEEP-SEATED LESIONS IN THE GI TRACT WITHOUT SURGERY: ENDOSCOPIC FULL THICKNESS RESECTION (EFTR)
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In modern medicine, endoscopy is the gold standard in the diagnosis and treatment of gastrointestinal (GI) tract conditions. Through endoscopy, the doctor can detect very small lesions, only a few millimeters, perform a biopsy to find cancer cells, and take tissue samples to diagnose a variety of digestive diseases. However, in some cases, lesions may lie deep in the wall of the GI tract, which requires special techniques such as full-thickness resection to remove them. One of the newest technologies to treat those deep growths without surgery is endoscopic full thickness resection (EFTR) using the full-thickness resection device (FTRD).
In the past, once a deep-seated lesion or early tumor has been identified and cannot be removed with complex tissue resection techniques such as endoscopic submucosal dissection (ESD), patients may require a surgical resection. The FTRD allows the endoscopist to achieve a thicker portion of resection to achieve oncologic resection, similar to that of surgical resection. In addition, a complete tissue resection in one-piece helps to stratify early cancerous lesions, i.e., if it shows evidence of lymphatic, vascular, or nerve invasions, so that the multidisciplinary tumor board can make a decision on the next step of management.
The Bumrungrad Digestive Disease Center team, led by US-trained Clinical Associate Prof. Dr. Tossapol Kerdsirichairat, is the first in Thailand and one of the very few in the regions to receive intensive training and regularly practice this technique.
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