ASGE guideline for endoscopic full-thickness resection and submucosal tunnel endoscopic resection
Harry R. Aslanian, MD, FASGE,
Amrita Sethi, MD, FASGE,
Manoop S. Bhutani, MD, FASGE,
Adam J. Goodman, MD, FASGE,
Kumar Krishnan, MD,
David R. Lichtenstein, MD, FASGE,
Joshua Melson, MD, FASGE,
Udayakumar Navaneethan, MD,
Rahul Pannala, MD, MPH, FASGE,
Mansour A. Parsi, MD, MPH, FASGE,
Allison R. Schulman, MD, MPH,
Shelby A. Sullivan, MD,
Nirav Thosani, MD,
Guru Trikudanathan, MBBS, MD,
Arvind J. Trindade, MD,
Rabindra R. Watson, MD,
John T. Maple, DO, FASGE
Affiliations
Harry R. Aslanian, MD, FASGE
Section of Digestive Diseases, Department of Internal Medicine, Yale University, New Haven, Connecticut
Amrita Sethi, MD, FASGE
Division of Digestive and Liver Diseases, Columbia University Medical Center/New York-Presbyterian, New York, New York
Manoop S. Bhutani, MD, FASGE
Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, The University of Texas, Houston, Texas
Adam J. Goodman, MD, FASGE
Division of Gastroenterology and Hepatology, NYU Langone Medical Center, New York University School of Medicine, New York, New York
Kumar Krishnan, MD
Division of Gastroenterology, Department of Internal Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts
David R. Lichtenstein, MD, FASGE
Division of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
Joshua Melson, MD, FASGE
Division of Digestive Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
Udayakumar Navaneethan, MD
Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida
Rahul Pannala, MD, MPH, FASGE
Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona
Mansour A. Parsi, MD, MPH, FASGE
Section for Gastroenterology and Hepatology, Tulane University Health Sciences Center, New Orleans, Louisiana
Allison R. Schulman, MD, MPH
Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan
Shelby A. Sullivan, MD
Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, Colorado
Nirav Thosani, MD
Division of Gastroenterology, Hepatology and Nutrition, McGovern Medical School, UTHealth, Houston, Texas
Guru Trikudanathan, MBBS, MD
Division of Gastroenterology, University of Minnesota, Minneapolis, Minnesota
Arvind J. Trindade, MD
Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, New York
Rabindra R. Watson, MD
Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California
John T. Maple, DO, FASGE
Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; Reprint requests: John T. Maple, DO, FASGE, ASGE Technology Committee Chair, 800 Stanton L Young Blvd, AAT 7400, Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
With the development of reliable endoscopic closure techniques and tools, endoscopic full-thickness resection (EFTR) is emerging as a therapeutic option for the treatment of subepithelial tumors and epithelial neoplasia with significant fibrosis. EFTR may be categorized as “exposed” and “nonexposed.” In exposed EFTR, the full-thickness resection is undertaken with a tunneled or nontunneled technique, with subsequent closure of the defect. In nonexposed EFTR, a secure serosa-to-serosa apposition is achieved before full-thickness resection of the isolated lesion. This document reviews current techniques and devices used for EFTR and reviews clinical applications and outcomes.
