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Safety and efficacy of a novel powered endoscopic debridement tissue resection device for management of difficult colon and foregut lesions: first multicenter U.S. experience

      Background and Aims

      The EndoRotor, nonthermal, powered endoscopic debridement (PED) instrument (Interscope Inc, Whitinsville, Mass, USA), is a novel device used in the GI tract. It uses adjustable suction and a rotary cutting blade to precisely resect mucosal and submucosal tissue. Our aim was to assess the technical feasibility, safety, and efficacy of PED using the EndoRotor device.

      Methods

      This was an Institutional Review Board–approved, multicenter, retrospective review. Patients underwent PED with the EndoRotor device from August 2018 to September 2019 at 4 high-volume U.S. centers. Patient demographics, indication for PED, and procedural and histopathologic data were recorded.

      Results

      Thirty-four patients underwent PED (41 lesions). The most common indications for PED were colon polyps (18, 52.9%) and Barrett’s esophagus (8, 23.5%). Most lesions (35, 85.4%) were resected previously for the same indication using standard techniques. Technical success was achieved in 97.6% of lesions (n = 40). Clinical success was achieved in most patients who underwent a follow-up examination (19, 79.2%). Intraprocedural bleeding (in 10 patients) was managed endoscopically; no EndoRotor-related perforations occurred. Three postprocedural adverse events occurred: self-limited chest pain in 1 patient and delayed bleeding in 2.

      Conclusions

      The EndoRotor is a novel, effective, and safe PED device for endoscopic resection of flat and polypoid lesions in the colon and foregut. It may have a promising role in the endoscopic management of naïve and scarred mucosal lesions based on this initial experience. Further prospective studies are needed to clarify its role in endoluminal resection.

      Abbreviations:

      EMR (endoscopic mucosal resection), ESD (endoscopic submucosal dissection), PED (powered endoscopic debridement)
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      References

        • Dumoulin F.L.
        • Hildenbrand R.
        Endoscopic resection techniques for colorectal neoplasia: Current developments.
        World J Gastroenterol. 2019; 25: 300-307
        • Hollerbach S.
        • Wellmann A.
        • Meier P.
        • et al.
        The EndoRotor((R)): endoscopic mucosal resection system for non-thermal and rapid removal of esophageal, gastric, and colonic lesions: initial experience in live animals.
        Endosc Int Open. 2016; 4: E475-E479
        • Knabe M.
        • Blosser S.
        • Wetzka J.
        • et al.
        Non-thermal ablation of non-neoplastic Barrett's esophagus with the novel EndoRotor(R) resection device.
        United Eur Gastroenterol J. 2018; 6: 678-683
        • Kandiah K.
        • Subramaniam S.
        • Chedgy F.
        • et al.
        A novel non-thermal resection tool in endoscopic management of scarred polyps.
        Endosc Int Open. 2019; 7: E974-E978
        • Kandel P.
        • Wallace M.B.
        Colorectal endoscopic mucosal resection (EMR).
        Best Pract Res Clin Gastroenterol. 2017; 31: 455-471
        • Gessl I.
        • Waldmann E.
        • Penz D.
        • et al.
        Resection rates and safety profile of cold vs. hot snare polypectomy in polyps sized 5-10 mm and 11-20 mm.
        Dig Liver Dis. 2019; 51: 536-541
        • Zhang Q.
        • Gao P.
        • Han B.
        • et al.
        Polypectomy for complete endoscopic resection of small colorectal polyps.
        Gastrointest Endosc. 2018; 87: 733-740
        • Pimentel-Nunes P.
        • Dinis-Ribeiro M.
        • Ponchon T.
        • et al.
        Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) guideline.
        Endoscopy. 2015; 47: 829-854
        • Fujiya M.
        • Tanaka K.
        • Dokoshi T.
        • et al.
        Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection.
        Gastrointest Endosc. 2015; 81: 583-595
        • Thota P.N.
        • Arora Z.
        • Dumot J.A.
        • et al.
        Cryotherapy and radiofrequency ablation for eradication of barrett's esophagus with dysplasia or intramucosal cancer.
        Dig Dis Sci. 2018; 63: 1311-1319
        • Qumseya B.J.
        • Wani S.
        • Desai M.
        • et al.
        Adverse events after radiofrequency ablation in patients with barrett's esophagus: a systematic review and meta-analysis.
        Clin Gastroenterol Hepatol. 2016; 14: 1086-1095