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Complete defect closure of gastric submucosal tumors with purse-string sutures

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Abstract

Background

Gastric submucosal tumors (SMTs) originating from the muscularis propria layer are treated endoscopically. Successful closure of the wall defect is a critical step. This study evaluated the safety and feasibility of the endoscopic purse-string suture (EPSS) method using an endoloop and several metallic clips after endoscopic full-thickness resection (EFTR) or perforation due to endoscopic submucosal dissection (ESD).

Methods

From December 2009 to April 2013, 30 patients with SMTs originating from the muscularis propria layer who received EFTR or ESD were retrospectively analyzed. After successful tumor resection, an endoloop was anchored onto the circumferential margin of the gastric defect with several metallic clips and tightened gently. Patient characteristics, tumor size, en bloc resection, and postoperative complications were evaluated.

Results

For all 30 patients, EPSS was successfully performed after EFTR or perforation due to ESD. The mean diameter of the resected specimen was 1.9 cm. No severe complications occurred during or after the procedure. The lesions were healed 1 month after the procedure, as confirmed endoscopically.

Conclusion

The EPSS method using an endoloop and clips is an effective and safe technique for closing the gastric defect after EFTR or perforation due to ESD.

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Acknowledgments

The study was partially supported by grants from the National Natural Science Foundation of China (No. 81172266), the Natural Science Foundation of Jiangsu Province (BK2011859), and Jiangsu Innovation of Medical Team and Leading Talents Cultivation (LJ201127).

Disclosure

Yin Zhang, Xiang Wang, Guanying Xiong, Yun Qian, Honggang Wang, Li Liu, Lin Miao, Zhining Fan have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Yin Zhang, Xiang Wang, Guanying Xiong, Yun Qian, Honggang Wang, Li Liu, Lin Miao & Zhining Fan

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  1. Yin Zhang
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  2. Xiang Wang
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  3. Guanying Xiong
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  4. Yun Qian
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  5. Honggang Wang
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  6. Li Liu
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  7. Lin Miao
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  8. Zhining Fan
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Corresponding author

Correspondence to Zhining Fan.

Additional information

Yin Zhang and Xiang Wang contributed equally to this article.

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Zhang, Y., Wang, X., Xiong, G. et al. Complete defect closure of gastric submucosal tumors with purse-string sutures. Surg Endosc 28, 1844–1851 (2014). https://doi.org/10.1007/s00464-013-3404-7

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  • DOI: https://doi.org/10.1007/s00464-013-3404-7

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