EFTR (Endoscopic Full-thickness Resection)


Endoscopic full-thickness resection (EFTR) is one of the advanced endoscopic procedures. This procedure is especially used to remove tumoral lesions involving all layers of the stomach or intestines. If you have tumors such as colon polyps or gastrointestinal (GI) stromal tumors, your doctor may recommend removing these growths using a procedure called endoscopic full-thickness resection (EFTR).

The treatment of lesions in the gastrointestinal tract is constantly evolving. Even highly complex conditions can now be treated with methods that do not require surgical intervention. Endoscopic full-thickness resection (EFTR) is one of the newest and most effective techniques in this field.

What is EFTR?

Endoscopic full-thickness resection, or EFTR, is a minimally invasive procedure used to remove (resect) benign or cancerous tumors from the gastrointestinal tract using a flexible, tube-like instrument, the endoscope.

“Full-thickness” refers to how much of the gastrointestinal wall is removed. While other procedures may only remove the superficial layers (mucosa and submucosa), the EFTR procedure aims to remove deeper tissues to ensure complete removal of the tumor.

EFTR is typically an outpatient procedure. Many patients are discharged the next day and can go home. Specially trained gastroenterologists (doctors who treat the GI tract) perform EFTR. Patients who undergo EFTR may have a shorter treatment time and faster recovery than patients who undergo more invasive surgery.

EFTR Who is it suitable for?

EFTR can be used to treat lesions in any part of the gastrointestinal tract. In particular, lesions that extend beyond the mucosa or submucosa layers or invade the entire mucosa can be effectively removed with this procedure.

EFTR is very effective in removing tumors located deep within the GI wall. Due to the location of these growths, other procedures increase the risk of complications such as rupture or perforation of the tissue.

In addition to deep tumors, doctors can also use EFTR for:

  • Removal of polyps in the stomach, small intestine or colon (polypectomy)
  • closing holes or openings between organs or tissues
  • to help a gastroenterologist identify the source of a problem, such as pain or bleeding. EFTR can help doctors collect a tissue sample to be examined under a microscope for signs of disease (biopsy).

EFTR may be better than endoscopic mucosal resection or endoscopic submucosal dissection for safely removing tumors in the shallow layers of the GI wall that adhere to the muscle layer. In these cases, EFTR is more sensitive in separating the tumor from the muscle.

EFTR Application and Advantages

Special equipment is used during the EFTR procedure. First, the location and borders of the lesion are determined. Then, an area large enough to include the lesion and some normal tissue around this area is grasped with a trap-style endoscopic apparatus and then the lesioned area is removed to include the entire stomach or intestinal wall. With this method, some lesions that previously required surgery can now be removed with an endoscopic procedure without the need for surgery.

The biggest advantage of EFTR is that lesions in the gastrointestinal tract can be completely removed. This allows patients to recover faster and comes with less risk of complications. Furthermore, lesions removed with EFTR provide a more accurate histologic assessment. This helps the doctor to better understand the patient’s condition and create a more accurate treatment plan if needed.

Endoscopic Full Thorough Resection (EFTR) is a highly effective method of treating lesions in the gastrointestinal tract. This technique allows lesions to be completely removed and patients recover faster. However, EFTR can be a complex procedure and should therefore be performed by an experienced endoscopist. If you are considering this type of procedure, it is important to talk to your doctor and determine the best option for you.

Risks and Complications

Because EFTR is a minimally invasive procedure, it involves fewer complications than laparoscopic or open procedures to remove lesions from your GI tract.

Some minor risks of EFTR include

  • Incomplete removal of a cancerous lesion
  • Diverticulitis
  • Perforation
  • Bleeding
  • Infection

The risk of acute appendicitis after EFTR is increased if tissue is harvested close to the appendiceal opening during the procedure.