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.

中文翻译：

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新型动力内窥镜清创组织切除装置用于处理困难的结肠和前肠病变的安全性和有效性：美国首个多中心经验

背景和目标

EndoRotor非热动力内窥镜清创术（PED）仪器（Interscope Inc，美国马萨诸塞州惠廷斯维尔）是一种用于胃肠道的新型装置。它使用可调节的吸力和旋转切割刀片来精确切除粘膜和粘膜下组织。我们的目的是评估使用EndoRotor设备的PED的技术可行性，安全性和有效性。

方法

这是机构审查委员会批准的多中心回顾性审查。从2018年8月至2019年9月，患者在美国4个高容量中心接受了EndoRotor设备的PED治疗。记录患者的人口统计资料，PED指征以及手术和组织病理学数据。

结果

34例患者接受了PED（41个病灶）。PED最常见的适应症是结肠息肉（18，52.9％）和巴雷特食管（8，23.5％）。对于大多数病变（35％，85.4％），先前已使用标准技术将其切除以达到相同的适应症。97.6％的病变获得了技术成功（n = 40）。大多数接受随访检查的患者均取得了临床成功（19，79.2％）。内镜处理术中出血（10例）。没有发生与EndoRotor相关的穿孔。发生了三项术后不良事件：1例患者的自限性胸痛和2例出血延迟。

结论

EndoRotor是一种新颖，有效且安全的PED装置，可用于内镜切除结肠和前肠中的扁平和息肉状病变。根据这一初步经验，它可能在内窥镜治疗幼稚和瘢痕性粘膜病变中发挥重要作用。需要进一步的前瞻性研究来阐明其在腔内切除术中的作用。