The prepurse-string suture technique for gastric defect after endoscopic full-thickness resection (with video)

Area of Science:

• Gastroenterology
• Surgical Endoscopy
• Oncology

Background:

• Endoscopic full-thickness resection (EFTR) is vital for gastric tumors originating from the muscularis propria or with extra-luminal growth.
• Effective closure of the gastric wall defect post-EFTR is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the feasibility and safety of the endoscopic prepurse-string suture (p-EPSS) technique for closing gastric perforations during EFTR.
• To assess the efficacy of using an endoloop and metallic clips for defect closure.

Main Methods:

• A retrospective analysis of 25 patients undergoing EFTR for gastric tumors between June 2016 and May 2017.
• Evaluation of patient and tumor characteristics, operation time, and postoperative complications.
• Application of the p-EPSS technique for gastric wall defect closure.

Main Results:

• All 25 patients successfully underwent EFTR with complete gastric defect closure.
• The mean operation time was 31 ± 14 minutes; mean tumor size was 1.7 ± 1.0 cm.
• No severe postoperative complications (bleeding, leak, peritonitis, abscess) or need for surgery were observed. Wounds healed within 1 month, with no recurrence during median 7-month follow-up.

Conclusions:

• The endoscopic prepurse-string suture (p-EPSS) technique, utilizing an endoloop and hemostasis clips, is a safe and feasible method for closing gastric perforations after EFTR.
• This technique facilitates successful EFTR by ensuring reliable defect closure and preventing major complications.