Hybrid rescue resection of a recurrent fibrotic adenoma in the ascending colon by combining Endoscopic Submucosal Dissection (ESD) and Full Thickness Resection Device (FTRD)

Abstract Text We describe a hybrid ESD+FTRD technique for the endoscopic removal of a recurrent fibrotic adenoma of the ascending colon. A 20-mm 0-IIa adenoma with an obvious scar of the previous resection attempt, was firstly removed with ESD by using a needle-type knife. However, the presence of severe fibrosis and difficulty to approach the lesion, the ESD procedure was interrupted, and hybrid ESD/FTRD was decided. Histology results confirmed R0 full-thickness resection and showed tubular adenoma with high-grade dysplasia. At 6 months after the procedure an endoscopy revealed no recurrence of the resected adenoma.