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The value of single-channel endoscopic traction and kiss suture technique in closing wounds caused by endoscopic resection of gastrointestinal muscularis propria tumors

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Abstract

Background

To investigate the value of single forceps endoscopic traction stapling suture technique (SFETSST) in closing wounds caused by endoscopic resection of gastrointestinal muscularis propria tumor (GMPT).

Methods

Consecutive patients who underwent submucosal tumor excavation (ESE) and endoscopic full-thickness resection (EFR) for GMPT in the Second Affiliated Hospital of Xiamen Medical College from January 2015 to January 2022 were retrospectively collected. They were divided into the SFETSST group and the standard group (patients who receive single forceps traction-free endoscopic suture technique). The healing effects were compared between the two groups.

Results

Seventy-seven patients were included in our study with 50 patients included in SFETSST group. The baseline characteristics had no significant difference between the two groups. The technical success rate of wound suture in SFETSST cluster was significantly upper than that within standard cluster (100% vs. 88.89%, P = 0.04). The wound suture time in SFETSST cluster was significantly lower than that within standard cluster (33.19 ± 10.64 min, P < 0.001). Moreover, the incidence rates of intra-operative and postoperative complications in SFETSST cluster were lower than standard cluster (0 vs. 7.41%, P = 0.051 and 0 vs. 11.11%, P = 0.016). Interestingly, the SFETSST cluster had lower cost of consumables (2485.40 ± 591.78 vs. 4098.52 ± 1903.06 Yuan, P = 0.01) and shorter hospital stay (4.96 ± 0.90 vs. 7.19 ± 2.45, P < 0.001) than standard cluster.

Conclusion

Our study showed that to fully closure the full-thickness defects of digestive tract, SFETSST was effective, safe, and economical, which was worth popularizing.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Wang H, Tan Y, Zhou Y, Wang Y, Li C, Zhou J, Duan T, Zhang J, Liu D (2015) Submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors originating from the muscularis propria layer. Eur J Gastroenterol Hepatol 27:776–780

    Article  PubMed  Google Scholar 

  2. Nishida T, Kawai N, Yamaguchi S, Nishida Y (2013) Submucosal tumors: comprehensive guide for the diagnosis and therapy of gastrointestinal submucosal tumors. Dig Endosc 25:479–489

    Article  PubMed  Google Scholar 

  3. Paspatis GA, Dumonceau JM, Barthet M, Meisner S, Repici A, Saunders BP, Vezakis A, Gonzalez JM, Turino SY, Tsiamoulos ZP, Fockens P, Hassan C (2014) Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 46:693–711

    Article  PubMed  Google Scholar 

  4. Xu MD, Cai MY, Zhou PH, Qin XY, Zhong YS, Chen WF, Hu JW, Zhang YQ, Ma LL, Qin WZ, Yao LQ (2012) Submucosal tunneling endoscopic resection: a new technique for treating upper GI submucosal tumors originating from the muscularis propria layer (with videos). Gastrointest Endosc 75:195–199

    Article  PubMed  Google Scholar 

  5. Granata A, Martino A, Ligresti D, Zito FP, Amata M, Lombardi G, Traina M (2021) Closure techniques in exposed endoscopic full-thickness resection: overview and future perspectives in the endoscopic suturing era. World J Gastrointest Surg 13:645–654

    Article  PubMed  PubMed Central  Google Scholar 

  6. Mangiavillano B, Viaggi P, Masci E (2010) Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: a literature review. J Dig Dis 11:12–18

    Article  PubMed  Google Scholar 

  7. Weiland T, Fehlker M, Gottwald T, Schurr MO (2013) Performance of the OTSC System in the endoscopic closure of iatrogenic gastrointestinal perforations: a systematic review. Surg Endosc 27:2258–2274

    Article  PubMed  Google Scholar 

  8. Akimoto T, Goto O, Nishizawa T, Yahagi N (2017) Endoscopic closure after intraluminal surgery. Dig Endosc 29:547–558

    Article  PubMed  Google Scholar 

  9. Modayil RJ, Zhang X, Khodorskiy D, Stavropoulos SN (2020) Advanced resection and closure techniques for endoscopic full-thickness resection in the gastric fundus. VideoGIE 5:61–63

    Article  PubMed  PubMed Central  Google Scholar 

  10. Xu MM, Angeles A, Kahaleh M (2018) Endoscopic full-thickness resection of gastric stromal tumor: one and done. Endoscopy 50:e42–e43

    Article  PubMed  Google Scholar 

  11. Mori H, Rahman A, Kobara H, Fujihara S, Nishiyama N, Ayaki M, Matsunaga T, Murakami M, Masaki T (2017) Current status of exposed endoscopic full-thickness resection and further development of non-exposed endoscopic full-thickness resection. Digestion 95:6–15

    Article  PubMed  Google Scholar 

  12. Casali PG, Blay JY, Abecassis N, Bajpai J, Bauer S, Biagini R, Bielack S, Bonvalot S, Boukovinas I, Bovee J, Boye K, Brodowicz T, Buonadonna A, De Álava E, Dei Tos AP, Del Muro XG, Dufresne A, Eriksson M, Fedenko A, Ferraresi V, Ferrari A, Frezza AM, Gasperoni S, Gelderblom H, Gouin F, Grignani G, Haas R, Hassan AB, Hindi N, Hohenberger P, Joensuu H, Jones RL, Jungels C, Jutte P, Kasper B, Kawai A, Kopeckova K, Krákorová DA, Le Cesne A, Le Grange F, Legius E, Leithner A, Lopez-Pousa A, Martin-Broto J, Merimsky O, Messiou C, Miah AB, Mir O, Montemurro M, Morosi C, Palmerini E, Pantaleo MA, Piana R, Piperno-Neumann S, Reichardt P, Rutkowski P, Safwat AA, Sangalli C, Sbaraglia M, Scheipl S, Schöffski P, Sleijfer S, Strauss D, Strauss SJ, Hall KS, Trama A, Unk M, van de Sande MAJ, van der Graaf WTA, van Houdt WJ, Frebourg T, Gronchi A, Stacchiotti S (2022) Gastrointestinal stromal tumours: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 33:20–33

    Article  CAS  PubMed  Google Scholar 

  13. Kondo H, Gotoda T, Ono H, Oda I, Kozu T, Fujishiro M, Saito D, Yoshida S (2004) Percutaneous traction-assisted EMR by using an insulation-tipped electrosurgical knife for early stage gastric cancer. Gastrointest Endosc 59:284–288

    Article  PubMed  Google Scholar 

  14. Kobayashi T, Gotohda T, Tamakawa K, Ueda H, Kakizoe T (2004) Magnetic anchor for more effective endoscopic mucosal resection. Jpn J Clin Oncol 34:118–123

    Article  PubMed  Google Scholar 

  15. Abe S, Wu SYS, Ego M, Takamaru H, Sekiguchi M, Yamada M, Nonaka S, Sakamoto T, Suzuki H, Yoshinaga S, Matsuda T, Oda I, Saito Y (2020) Efficacy of current traction techniques for endoscopic submucosal dissection. Gut Liver 14:673–684

    Article  PubMed  PubMed Central  Google Scholar 

  16. Zhou PH, Yao LQ, Qin XY, Cai MY, Xu MD, Zhong YS, Chen WF, Zhang YQ, Qin WZ, Hu JW, Liu JZ (2011) Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc 25:2926–2931

    Article  PubMed  Google Scholar 

  17. Huang LY, Cui J, Lin SJ, Zhang B, Wu CR (2014) Endoscopic full-thickness resection for gastric submucosal tumors arising from the muscularis propria layer. World J Gastroenterol 20:13981–13986

    Article  PubMed  PubMed Central  Google Scholar 

  18. Dong HY, Wang YL, Jia XY, Li J, Li GD, Li YQ (2014) Modified laparoscopic intragastric surgery and endoscopic full-thickness resection for gastric stromal tumor originating from the muscularis propria. Surg Endosc 28:1447–1453

    Article  PubMed  Google Scholar 

  19. Tang AL, Liao XQ, Shen SR, Xiao DH, Yuan YX, Wang XY (2016) Application of clips assisted with foreign body forceps in defect closure after endoscopic full-thickness resection. Surg Endosc 30:2127–2131

    Article  PubMed  Google Scholar 

  20. Shi Q, Chen T, Zhong YS, Zhou PH, Ren Z, Xu MD, Yao LQ (2013) Complete closure of large gastric defects after endoscopic full-thickness resection, using endoloop and metallic clip interrupted suture. Endoscopy 45:329–334

    Article  CAS  PubMed  Google Scholar 

  21. Guo J, Liu Z, Sun S, Liu X, Wang S, Ge N, Wang G, Qi Y (2015) 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

    Article  PubMed  PubMed Central  Google Scholar 

  22. Du C, Ma L, Chai N, Gao Y, Niu X, Zhai Y, Li Z, Meng J, Tang P, Linghu E (2018) Factors affecting the effectiveness and safety of submucosal tunneling endoscopic resection for esophageal submucosal tumors originating from the muscularis propria layer. Surg Endosc 32:1255–1264

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, The Second Affiliated Hospital of Xiamen Medical College, No. 566 Jimei Shengguang Road, Xiamen, 361021, Fujian, China

    Xiaohua Li, Jie He, Zhongmei Zhu, Yaxuan Xiao, Yuecui Jiang, Qinghong Cheng & Youzhen Hu

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  1. Xiaohua Li
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  2. Jie He
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Correspondence to Xiaohua Li.

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Xiaohua Li, Jie He, Zhongmei Zhu, Yaxuan Xiao, Yuecui Jiang, Qinghong Cheng, and Youzhen Hu have no conflicts of interest or financial ties to disclose.

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Li, X., He, J., Zhu, Z. et al. The value of single-channel endoscopic traction and kiss suture technique in closing wounds caused by endoscopic resection of gastrointestinal muscularis propria tumors. Surg Endosc 37, 7709–7716 (2023). https://doi.org/10.1007/s00464-023-10277-6

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  • DOI: https://doi.org/10.1007/s00464-023-10277-6

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