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New endoscopic closure technique, “internal traction–assisted suspended closure,” for GI defect closure: a pilot study (with video) - 16/01/24

Doi : 10.1016/j.gie.2023.08.010 
Yaoyao Gong, MD 1, , Jue Wang, MD 2, , Tianyin Chen, MD 2, Jing Cheng, MD 2, Keyi Guo, MS 2, Wei Su, MD 2, Pinghong Zhou, MD, FASGE 2, Jianwei Hu, MD 2,
1 Department of Gastroenterology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China 
2 Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, China 

Reprint requests: Jianwei Hu, MD and Pinghong Zhou, MD, FASGE, Endoscopy Center, Zhongshan Hospital, Fudan University, No. 180 of Fenglin Rd, Shanghai 200032, China.Endoscopy CenterZhongshan HospitalFudan UniversityNo. 180 of Fenglin RdShanghai200032China

Abstract

Background and Aims

After endoscopic full-thickness resection (EFTR), reliable closure of the perforation is critical. However, it is technically difficult to close some defects by using metal clips alone or by purse-string suturing, which may lead to unreliable closure. Inspired by the process of pulling up the 2 ends of the incision in the surgical suture, we developed a new endoscopic closure technique, the “internal traction–assisted suspended closure” technique. This pilot study was performed as an initial evaluation of the feasibility and safety of this new endoscopic closure technique.

Methods

Data from patients in whom this suspended closure technique was used to close full-thickness defects after EFTR were retrospectively reviewed. The primary outcome was successful closure rate. Secondary outcomes were closure time, length of postprocedural hospital stay, and incidence of postprocedural adverse events. Defect size and tumor characteristics were also analyzed.

Results

Eight patients who underwent the suspended closure technique after EFTR were included. All patients were successfully treated with the suspended closure technique, and no patient developed serious adverse events. The median length of the defect was 3.25 cm (range, 2.5-9.0) and the median width was 2.8 cm (range, 1.8-6.0). The median closing time was 13 minutes (range, 6-24).

Conclusions

The internal traction–assisted suspended closure technique is a simple, reliable, and easy-to-use technique for large full-thickness defects after endoscopic resection.

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Graphical abstract




Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : EFTR, GIST, SET


Mappa


 DIVERSITY, EQUITY, AND INCLUSION: We worked to ensure gender balance in the recruitment of human subjects. The author list of this paper includes contributors from the location where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.


© 2024  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 99 - N° 2

P. 186 - febbraio 2024 Ritorno al numero
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