Novel closure method for a large mucosal defect after endoscopic resection: String clip suturing method with an...

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Surgical Innovation

Background:

• Duodenal endoscopic submucosal dissection (ESD) carries significant risks, with mucosal defect closure being a critical challenge.
• Large lesions in the duodenum present particular difficulties for standard closure techniques.

Purpose of the Study:

• To evaluate the feasibility and efficacy of a novel String Clip Suturing Method with an Anchor (SCSM-A) for closing mucosal defects after duodenal ESD.
• To assess the safety and outcomes of the SCSM-A technique in patients undergoing duodenal ESD.

Main Methods:

• The SCSM-A technique involves deploying clips at the defect ends and on the muscular layer, using a string to secure complete closure.
• Five patients with large duodenal mucosal defects (52–103 mm) post-ESD were treated using the SCSM-A method.
• Clinical courses and hospitalization details were reviewed for all participating patients.

Main Results:

• Complete closure of large mucosal defects was achieved in all five patients using the SCSM-A technique.
• No adverse events or complications were reported, and no additional treatments were necessary.
• All patients were discharged within seven days, indicating a safe and efficient recovery.

Conclusions:

• The SCSM-A technique provides secure and effective closure for large mucosal defects following duodenal ESD.
• This innovative method demonstrates potential applicability to other organs, such as the colon, for defect closure.