TY  - JOUR
A1  - Brand, Markus
A1  - Reimer, Stanislaus
A1  - Reibetanz, Joachim
A1  - Flemming, Sven
A1  - Kornmann, Marko
A1  - Meining, Alexander
T1  - Endoscopic full thickness resection vs. transanal endoscopic microsurgery for local treatment of rectal neuroendocrine tumors - a retrospective analysis
JF  - International Journal of Colorectal Disease
N2  - Purpose
Local treatment of small well-differentiated rectal neuroendocrine tumors (NETs) is recommended by current guidelines. However, although several endoscopic methods have been established, the highest R0 rate is achieved by transanal endoscopic microsurgery (TEM). Since a recently published study about endoscopic full thickness resection (eFTR) showed a R0 resection rate of 100%, the aim of this study was to evaluate both methods (eFTR vs. TEM).

Methods
We retrospectively analyzed all patients with rectal NET treated either by TEM (1999–2018) or eFTR (2016–2019) in two tertiary centers (University Hospital Wuerzburg and Ulm). We analyzed clinical, procedural, and histopathological outcomes in both groups.

Results
Twenty-eight patients with rectal NET received local treatment (TEM: 13; eFTR: 15). Most tumors were at stage T1a and grade G1 or G2 (in the TEM group two G3 NETs were staged T2 after neoadjuvant chemotherapy). In both groups, similar outcomes for en bloc resection rate, R0 resection rate, tumor size, or specimen size were found. No procedural adverse events were noted. Mean procedure time in the TEM group was 48.9 min and 19.2 min in the eFTR group.

Conclusion
eFTR is a convincing method for local treatment of small rectal NETs combining high safety and efficacy with short interventional time.
KW  - rectum
KW  - neuroendocrine tumor (NET)
KW  - transanal endoscopic microsurgery (TEM)
KW  - endoscopic full thickness resection (eFTR)
KW  - full-thickness resection device (FTRD)
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234833
SN  - 0179-1958
VL  - 36
ER  - 
TY  - JOUR
A1  - Lock, Johan F
A1  - Reimer, Stanislaus
A1  - Pietryga, Sebastian
A1  - Jakubietz, Rafael
A1  - Flemming, Sven
A1  - Meining, Alexander
A1  - Germer, Christoph-Thomas
A1  - Seyfried, Florian
T1  - Managing esophagocutaneous fistula after secondary gastric pull-up: A case report
JF  - World Journal of Gastroenterology
N2  - Background
Gastric pull-up (GPU) procedures may be complicated by leaks, fistulas, or stenoses. These complications are usually managed by endoscopy, but in extreme cases multidisciplinary management including reoperation may be necessary. Here, we report a combined endoscopic and surgical approach to manage a failed secondary GPU procedure.

Case summary
A 70-year-old male with treatment-refractory cervical esophagocutaneous fistula with stenotic remnant esophagus after secondary GPU was transferred to our tertiary hospital. Local and systemic infection originating from the infected fistula was resolved by endoscopy. Hence, elective esophageal reconstruction with free-jejunal interposition was performed with no subsequent adverse events.

Conclusion
A multidisciplinary approach involving interventional endoscopists and surgeons successfully managed severe complications arising from a cervical esophago-cutaneous fistula after GPU. Endoscopic treatment may have lowered the perioperative risk to promote primary wound healing after free-jejunal graft interposition.
KW  - esophageal fistula
KW  - gastric fistula
KW  - esophageal stenosis
KW  - esophageal perforation
KW  - endoscopic vacuum therapy
KW  - free-jejunal graft
KW  - autogenous jejunum transplantation
KW  - case report
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-369417
VL  - 27
ER  -