Feasibility of repeat non-exposed endoscopic full-thickness resection of recurrent or residual colonic adenoma after previous full-thickness resection.

Background and study aims: Endoscopic full-thickness resection (EFTR) can be used to treat recurrent or residual colorectal adenomas. No data are available on treatment of recurrences after EFTR, especially on feasibility and safety of repeat EFTR (re-EFTR). Patients and methods: This single-center retrospective study included patients who underwent device-assisted non-exposed re-EFTR in the colorectum. Technical success, adverse events (AEs), and recurrences were analyzed and compared to patients with primary EFTR. Results: Twenty-seven patients who underwent re-EFTR were included. Median age was 75 years (range: 54-85 years) and nine patients were female (33.3%). The indication for re-EFTR was recurrent adenoma in 24 patients (88.9%) and most lesions were in the right-sided colon (n = 22; 81.5%). Technical success was achieved in 22 patients (81.5%). Reasons for failure were failure to reach the lesion in one case and inability to fully mobilize the lesion into the cap in four cases. Follow-up after 2 to 6 months revealed recurrent lesion in four of 24 cases (16.7%) and four more occurred during further follow-up. Surgery was necessary in two cases. AEs occurred in two cases (7.4%). Comparison with primary EFTR showed a trend toward lower technical success (81.5% vs. 100.0%, Conclusions: Repeat EFTR for recurrence after a previous EFTR is feasible in most patients and only a few patients require surgical resection. The rate of recurrence might be higher than that after primary EFTR, yet there are no differences in AEs.