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A modified exposed endoscopic full-thickness resection: Traction-assisted resection while defect closing.

Nan Ru1, Long Song Li1, Ya Wei Bi1

  • 1Department of Gastroenterology, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.

Journal of Digestive Diseases
|June 10, 2023
PubMed
Summary

A modified traction-assisted exposed endoscopic full-thickness resection (Eo-EFTR) technique simplifies gastric submucosal tumor (SMT) removal and defect closure. This safe and practical method shows promise for widespread clinical application.

Keywords:
endoscopic full-thickness resectionendoscopygastric submucosal tumortraction

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Endoscopic Surgery

Background:

  • Exposed endoscopic full-thickness resection (Eo-EFTR) is effective for gastric submucosal tumors (SMTs).
  • Challenges include poor visualization, tumor displacement, and difficult defect closure.
  • These limitations hinder widespread adoption of Eo-EFTR.

Purpose of the Study:

  • To describe a modified traction-assisted Eo-EFTR technique.
  • To simplify dissection and defect closure in gastric SMTs.
  • To evaluate the safety and efficacy of this modified approach.

Main Methods:

  • A modified traction-assisted Eo-EFTR was performed on 19 patients with gastric SMTs.
  • A clip with dental floss was used for traction on the resected tumor.
  • This facilitated V-shaped defect reshaping for easier clip closure, alternating with dissection.

Main Results:

  • Complete tumor resection (R0) was achieved in all cases.
  • Median procedure time was 43 minutes.
  • No severe adverse events; minor transient symptoms (fever, pain) resolved quickly.
  • No recurrence during a 30.1-month follow-up.

Conclusions:

  • The modified traction-assisted Eo-EFTR technique is safe and practical.
  • It simplifies gastric SMT resection and defect closure.
  • This approach holds potential for broad clinical application of Eo-EFTR.