endoscopic full thickness resection

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tjhilliard
Posts: 3
Joined: Tue Mar 20, 2018 3:05 pm

endoscopic full thickness resection

Postby tjhilliard » Fri Sep 07, 2018 6:22 pm

I previously posted about my doctor's desire to surgically remove part of my ascending colon to remove Precancerous cells. This would include the cecum. I have had three colonoscopies and it keeps coming back. Since I am 74, have some heart issues, and take Xarelto, I would like to steer away from surgery. Someone suggested a mucosal resection (EMR) but they don't think it would be possible due to scar tissue from the previous procedures. Three doctors are in agreement on that. One suggested a laser treatment which would require two procedures plus a third procedure to check and would have a 50% chance of working. Feel free to weight in on that but I don't think I will do it.

A third option is a new procedure called endoscopic full thickness resection (EFTR) takes a full piece of the colon out. The problem is that there are very few hospitals with the equipment and just as few people trained in it. I met a local doctor trained but the hospital has not decided to buy the device. Generally, only the large prestige hospitals are using the procedure. That would involve something like Mayo, NYU, or John Hopkins. Probably Johns Hopkins in Baltimore.

Does anyone have experience with this procedure or know some one who does? Any thoughts will be appreciated.

martd
Posts: 128
Joined: Tue Nov 21, 2017 3:48 pm
Location: Phoenix, Az

Re: endoscopic full thickness resection

Postby martd » Fri Sep 07, 2018 10:15 pm

I don't have any info on that procedure, but it might be worth a call to one of the major centers you mentioned. Many of them have housing assistance programs for traveling from out of state. The Mayo here in Phoenix has a Marriott residence inn next door pretty much exclusive to Mayo. And the American Cancer Society and others have programs to assist also. Not sure this even pertains to you but thought I'd share it in case it helps. Good luck to you

Dan
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT Tp53 LOF
12 rounds folfox , avastin
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7
01/19 clear scan CEA .9
04/19 clear scan CEA .9
07/19 clear scan CEA 1.0

Jannine
Posts: 204
Joined: Wed Jun 20, 2018 7:46 am
Location: Maryland, USA

Re: endoscopic full thickness resection

Postby Jannine » Sat Sep 08, 2018 7:55 am

I also can't answer the question about this type of resection, but I did find info about Johns Hopkins short term housing for cancer patients on the web:

https://www.hopkinsmedicine.org/the_joh ... using.html

Hopkins is definitely a good place to go for unusual procedures and difficult cases (based on both their international and local rep; I am a local).

I would definitely get an opinion from one of the major cancer centers that have a lot of expertise in unusual cases first, to make sure your expected approach is really what's best for you, then go from there.
DX: sigmoid colon cancer 5/2018. 48 F
laparoscopic sigmoid resection (24 cm removed); no stoma.
7.5cm adenocarcinoma -- mod. diff.
1 noncontiguous tumor deposit removed; 0/31 lymph nodes
T3 pN1c M0
5/18 before surgery, CEA 11.2
6/18 began FOLFOX
7/18: CEA 1.9; added neulasta post infusion
9/18: CEA 2.8
10/18: 25% chemo reduction
11/18: CEA 1.8
7/19 CT scan clear

tjhilliard
Posts: 3
Joined: Tue Mar 20, 2018 3:05 pm

Re: endoscopic full thickness resection

Postby tjhilliard » Thu Sep 20, 2018 4:28 am

Thanks for the replies. This procedure is rarely performed since it is so new but it appears that it will happen. They called from Johns Hopkins today to start scheduling the procedure. I will try to keep everyone informed on how it goes.

Tom

martd
Posts: 128
Joined: Tue Nov 21, 2017 3:48 pm
Location: Phoenix, Az

Re: endoscopic full thickness resection

Postby martd » Fri Sep 21, 2018 11:51 am

That's good news Tom. I hope it goes well wishing you the best.
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT Tp53 LOF
12 rounds folfox , avastin
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7
01/19 clear scan CEA .9
04/19 clear scan CEA .9
07/19 clear scan CEA 1.0


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