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Endoscopic full-thickness resection with defect closure using an over-the-scope clip for gastric subepithelial tumors originating from the muscularis propria

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Abstract

Background

Endoscopic full-thickness resection (EFTR) is a mini-invasive technique for gastric subepithelial tumors originating from the muscularis propria, which enables a full-thickness resection of tumors and can provide a complete basis for pathological diagnosis. Gastric fistula closure after EFTR is a challenge for endoscopists. In this study, we introduced EFTR with fistula closure using the over-the-scope clip (OTSC) system for gastric subepithelial tumors originating from the muscularis propria.

Objectives

To evaluate the feasibility and safety of fistula closure with OTSC by a retrospective analysis on the cases of EFTR with defect closure using OTSC for gastric subepithelial tumors originating from the muscularis propria in our hospital.

Methods

The patients were selected who underwent EFTR for gastric subepithelial tumors originating from the muscularis propria (tumor diameter ≤2 cm) in our hospital from October 2013 to March 2014. After a full-thickness resection of tumors, the bilateral gastric mucous membranes of defect were clamped using twin graspers and then drawn into the transparent cap of OTSC, and the OTSC was released to close the defect after full suctioning. The success rate of defect closure with OTSC was observed, and the endoscopic follow-up was performed at 1 week, 1 and 6 months after operation to check OTSC closure.

Results

Totally 23 patients were included into the study. The full-thickness resection rate of gastric tumors in the muscularis propria was 100 % (23/23), the success rate of defect closure was 100 %, and the average time of defect closure was 4.9 min (range 2–12 min). All patients experienced no postoperative complications such as bleeding and perforation. The postoperative follow-up time was 1–6 months (mean 3 months), and no OTSC detachment was found.

Conclusions

OTSC can be used to perform EFTR with defect closure for gastric tumors in the muscularis propria (tumor diameter ≤2 cm). It is simple, convenient, safe and effective.

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Acknowledgments

This study was supported by the National Natural Science Foundation of China (Grant No. 81071798), Medical Peak Project Foundation of Liaoning Province [Grant No. (2010)696]. We thank all of the doctors, nurses and pathologists who participated in this study.

Disclosures

Jintao Guo, Siyu Sun, Zhijun Liu, Xiang Liu, Sheng Wang, Nan Ge, Guoxin Wang and yafei Qi have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Endoscopic Center, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China

    Jintao Guo, Siyu Sun, Xiang Liu, Sheng Wang, Nan Ge & Guoxin Wang

  2. Ultrasound Department, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China

    Zhijun Liu

  3. Pathological Department, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning Province, China

    Yafei Qi

Authors
  1. Jintao Guo
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  2. Zhijun Liu
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  3. Siyu Sun
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  4. Xiang Liu
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  5. Sheng Wang
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  6. Nan Ge
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  7. Guoxin Wang
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Correspondence to Siyu Sun.

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Guo, J., Liu, Z., Sun, S. et al. Endoscopic full-thickness resection with defect closure using an over-the-scope clip for gastric subepithelial tumors originating from the muscularis propria. Surg Endosc 29, 3356–3362 (2015). https://doi.org/10.1007/s00464-015-4076-2

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  • DOI: https://doi.org/10.1007/s00464-015-4076-2

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