CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(08): E749-E753
DOI: 10.1055/s-0043-111593
Case report
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Use of the full-thickness resection device (FTRD) to prevent bleeding after colonic polypectomy in a patient with a left ventricular assist device

Richard F. Knoop
University Hospital Freiburg, University of Freiburg, Faculty of Medicine, Interdisciplinary Gastrointestinal Endoscopy, Department of Medicine II
,
Hans-Juergen Richer-Schrag
University Hospital Freiburg, University of Freiburg, Faculty of Medicine, Interdisciplinary Gastrointestinal Endoscopy, Department of Medicine II
,
Robert Thimme
University Hospital Freiburg, University of Freiburg, Faculty of Medicine, Interdisciplinary Gastrointestinal Endoscopy, Department of Medicine II
,
Andreas Fischer
University Hospital Freiburg, University of Freiburg, Faculty of Medicine, Interdisciplinary Gastrointestinal Endoscopy, Department of Medicine II
› Author Affiliations
Further Information

Publication History

submitted 02 March 2017

accepted after revision 29 March 2017

Publication Date:
07 August 2017 (online)

Abstract

Background and study aims Treatment of colorectal polyps in patients undergoing permanent anticoagulation is associated with a significantly increased risk of peri-interventional bleeding. This specifically applies to polyps > 1 cm where endoscopic full-thickness resection (EFTR) with the full-thickness-resection device (FTRD) can be taken into consideration as an alternative approach to classical snare polypectomy.

For these indications, EFTR appears to be superior to conventional techniques especially in terms of sufficient hemostasis due to the mechanical tissue compression achieved by the FTRDʼs integrated Over-The-Scope Clip (OTSC). This is demonstrated in the following case report of a 59-year-old male with a left ventricular assist device (LVAD) implanted due to congestive heart failure. He presented with intermittent hemorrhage from a large polyp in the ascending colon that was successfully treated via EFTR with the FTRD. A video is included.

 
  • References

  • 1 Kim HG, Friedland S. Safe and effective colon polypectomy in patients receiving uninterrupted anticoagulation: can we do it?. Gastrointest Endosc 2014; 79: 424-426
  • 2 Horiuchi A, Nakayama Y, Kajiyama M. et al. Removal of small colorectal polyps in anticoagulated patients: a prospective randomized comparison of cold snare and conventional polypectomy. Gastrointest Endosc 2014; 79: 417-423
  • 3 Schmidt A, Bauerfeind P, Gubler C. et al. Endoscopic full-thickness resection in the colorectum with a novel over-the-scope device: first experience. Endoscopy 2015; 47: 719-725
  • 4 Richter-Schrag HJ, Walker C, Thimme R. et al. [Full thickness resection device (FTRD) : Experience and outcome for benign neoplasms of the rectum and colon]. Chirurg 2016; 87: 316-325
  • 5 Fischer A, Knoop RF, Walker C. et al. Resection of a large rectal polyp with the simultaneous combination of snare polypectomy and full-thickness resection device resection. Endoscopy 2015; 47 (Suppl. 01) E607-608