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Endoscopic Full Thickness Resection (EFTR)

Endoscopic full thickness resection (EFTR) is an outpatient procedure to remove growths deep in the wall of the gastrointestinal (GI) tract. Our skilled physicians can use EFTR to treat tumors without surgery.  

Gastroenterologists (physicians specially trained to treat the GI tract) use a flexible, tube-like imaging instrument called an endoscope to look inside your body. With EFTR, physicians may be able to identify the source of a gastrointestinal problem, such as GI bleeding or pain. At the same time, they can remove growths, such as colon polyps or tumors. 

Endoscopic Full Thickness Resection: Why It’s Performed

In EFTR, our gastroenterologists use specially designed endoscopes that include a device to remove a tumor (such as a benign or cancerous growth). This design makes it possible for many patients to avoid a more invasive surgical procedure. The result may be a shorter treatment time and faster recovery.

EFTR is very effective for removing tumors located deep in the GI wall. Because of the location of these growths, other procedures could cause complications, such as tearing or perforation of tissue. It is more effective 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 addition to deep tumors, physicians may use EFTR for:

Endoscopic Full Thickness Resection: How to Prepare

Before your EFTR:

  • For a lower GI tract procedure, follow a liquid diet plus a laxative or enema to cleanse the bowel.
  • For an upper GI tract procedure, do not eat or drink for 12 hours before the procedure to clear your esophagus of food products.
  • Tell your doctor if you have any allergies.
  • Follow your doctor’s instructions about whether to take your prescription medications. 

Endoscopic Full Thickness Resection: What to Expect

On the day of your procedure, you need to arrive at the endoscopy unit up to three hours before the procedure. You will register and provide your medical history, including any medications you have taken. Plan for a driver to take you home after the procedure.

During the procedure, your gastroenterologist will:

  1. Insert an IV into your vein to deliver a sedative that will make you drowsy.
  2. Pass a high-definition endoscope through your mouth (for an upper GI tract procedure) or your anus (for a lower GI tract procedure). Your doctor will observe the images on a screen.
  3. Locate and mark the edges of the tumor with a tool inserted through the endoscope.
  4. Feed tiny forceps (tongs) through the endoscope to grasp the tumor.
  5. Use the forceps to pull the tumor up into the tube of the endoscope until the edges of the tumor are visible in the tube.
  6. Use a special clip on the endoscope to cut the tissue from the body. The clip remains safely in the body, acting as a suture.
  7. Carefully remove the tissue through the endoscope. In a laboratory, a technician will examine it under a microscope. The lab will confirm that the tumor was completely removed.

After the procedure, we’ll observe you in a recovery room while the effects of the sedative wear off. Your gastroenterologist will discuss your procedure and results with you before you leave.

Common side effects of EFTR may include:

  • Sore throat
  • Nausea or vomiting
  • Excessive gas, bloating or cramping
  • Mild abdominal pain or rectal pain

Related Diseases and Conditions: