Dongtao Shi1, Rui Li2, Weichang Chen1, Deqing Zhang1, Lei Zhang3, Rui Guo3, Ping Yao4, Xudong Wu5. 1. Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, China. 2. Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, China. lrhcsz@163.com. 3. Department of Gastroenterology, The People's Hospital of Donghai County, Lianyungang, China. 4. Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, China. 5. Department of Gastroenterology, The First People's Hospital of Yancheng City, Yancheng, China.
Abstract
BACKGROUND: The key step of the endoscopic full-thickness resection (EFTR) procedure is the successful closure of any gastric wall defect which ultimately avoids surgical intervention. This report presents a new method of closing large gastric defects left after EFTR, using metallic clips and novel endoloops by means of single-channel endoscope. METHODS: We retrospectively analyzed 68 patients who were treated for gastric fundus gastrointestinal stromal tumors originating from the muscularis propria layer at four institutes between April 2014 and February 2015 and consequently underwent EFTR. The large gastric post-EFTR defects were completely closed with metallic clips and novel endoloops using single-channel endoscope, and all the patients were discharged with subsequent endoscopic and clinical follow-up. Patient characteristics, tumor size, en bloc resection rate, closure operation time, and postoperative adverse events were evaluated. RESULTS: EFTR was successfully performed on 68 patients [41 male (60 %), 27 female (40 %); median age 61 years, range 38-73], and the en bloc resection rate was 100 %. Complete closure of all the gastric post-EFTR defects was achieved (success rate 100 %). The mean closure operation time was 13 min (range 9-21 min). The mean maximum size of the lesions was 2.6 cm (range 2.0-3.5 cm). One Mallory-Weiss syndrome and one delayed bleeding were resolved with nonsurgical treatment. The wounds were healed in all cases 1 month after the procedure. CONCLUSIONS: The use of metallic clips and novel endoloops with single-channel endoscope is a relatively safe, easy, and feasible method for repairing large gastric post-EFTR defects.
BACKGROUND: The key step of the endoscopic full-thickness resection (EFTR) procedure is the successful closure of any gastric wall defect which ultimately avoids surgical intervention. This report presents a new method of closing large gastric defects left after EFTR, using metallic clips and novel endoloops by means of single-channel endoscope. METHODS: We retrospectively analyzed 68 patients who were treated for gastric fundus gastrointestinal stromal tumors originating from the muscularis propria layer at four institutes between April 2014 and February 2015 and consequently underwent EFTR. The large gastric post-EFTR defects were completely closed with metallic clips and novel endoloops using single-channel endoscope, and all the patients were discharged with subsequent endoscopic and clinical follow-up. Patient characteristics, tumor size, en bloc resection rate, closure operation time, and postoperative adverse events were evaluated. RESULTS: EFTR was successfully performed on 68 patients [41 male (60 %), 27 female (40 %); median age 61 years, range 38-73], and the en bloc resection rate was 100 %. Complete closure of all the gastric post-EFTR defects was achieved (success rate 100 %). The mean closure operation time was 13 min (range 9-21 min). The mean maximum size of the lesions was 2.6 cm (range 2.0-3.5 cm). One Mallory-Weiss syndrome and one delayed bleeding were resolved with nonsurgical treatment. The wounds were healed in all cases 1 month after the procedure. CONCLUSIONS: The use of metallic clips and novel endoloops with single-channel endoscope is a relatively safe, easy, and feasible method for repairing large gastric post-EFTR defects.
Authors: Daniel von Renteln; Thomas Rösch; Thomas Kratt; Ulrike W Denzer; Muhammad El-Masry; Guido Schachschal Journal: Dig Dis Sci Date: 2012-02-28 Impact factor: 3.199
Authors: Gregorios A Paspatis; Jean-Marc Dumonceau; Marc Barthet; Søren Meisner; Alessandro Repici; Brian P Saunders; Antonios Vezakis; Jean Michel Gonzalez; Stine Ydegaard Turino; Zacharias P Tsiamoulos; Paul Fockens; Cesare Hassan Journal: Endoscopy Date: 2014-07-21 Impact factor: 10.093