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Application of clips assisted with foreign body forceps in defect closure after endoscopic full-thickness resection

  • Endoluminal Surgery
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Abstract

Background

This study was designed to evaluate the feasibility and efficacy of metallic clips assisted with foreign body forceps closing the gastric wall defect after endoscopic full-thickness resection (EFR) for gastric submucosal tumors (SMTs).

Methods

Eighteen patients with gastric SMTs originated from the muscularis propria were treated by EFR between September 2012 and June 2014. Twelve patients underwent endoscopic closure of the gastric wall defects after EFR with endoloop and metallic clips (endoloop string suture method, ESSM), and six patients with clips and foreign body forceps (clips assisted with foreign body forceps clip method, CFCM).

Results

No significant differences existed between the two groups in terms of demographics, clinical characteristics, and the size of the gastric wall defects. The average time spent in closing the gastric wall defects (14.83 ± 1.94 min for the CFCM group and 22.42 ± 5.73 min for the ESSM group) and hospitalization fees of the CFCM group were significantly lower than those of the ESSM group. The average hospitalization time of the two groups had no statistical significance. No single case had surgical intervention or complications, such as gastric bleeding, perforation, peritonitis, or abdominal abscess.

Conclusion

The CFCM and the ESSM are safe and effective techniques for gastric defect closure after EFR for gastric SMTs. Because of the “chopsticks effect,” the CFCM more suitable for the lesions located at the gastric fundus, the greater curvature or anterior wall of the gastric body and gastric antrum.

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References

  1. Zhou PH, Yao LQ, Qin XY, Cai MY, Xu MD, Zhong YS et al (2011) Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc Other Interv Tech 25(9):2926–2931

    Article  Google Scholar 

  2. Wang L, Ren W, Fan CQ, Li YH, Zhang X, Yu J et al (2011) Full-thickness endoscopic resection of nonintracavitary gastric stromal tumors: a novel approach. Surg Endosc Other Interv Tech 25(2):641–647

    Article  Google Scholar 

  3. Abe N, Takeuchi H, Yanagida O, Masaki T, Mori T, Sugiyama M et al (2009) Endoscopic full-thickness resection with laparoscopic assistance as hybrid NOTES for gastric submucosal tumor. Surg Endosc Other Interv Tech 23(8):1908–1913

    Article  Google Scholar 

  4. Ikeda K, Sumiyama K, Tajiri H, Yasuda K, Kitano S (2011) Evaluation of a new multitasking platform for endoscopic full-thickness resection. Gastrointest Endosc 73(1):117–122

    Article  PubMed  Google Scholar 

  5. Zhang Y, Wang X, Xiong GY, Qian Y, Wang HG, Liu L et al (2014) Complete defect closure of gastric submucosal tumors with purse-string sutures. Surg Endosc Other Interv Tech 28(6):1844–1851

    Article  Google Scholar 

  6. Zhang Y, Fan Z, Wu J, Huang X, Miao L, Wang X (2015) Endoscopic purse-string suture for the gastric wall defect after full-thickness resection. Zhonghua Wei Chang Wai Ke Za Zhi 18(2):150–154

    PubMed  Google Scholar 

  7. Ikeda K, Fritscher-Ravens A, Mosse CA, Mills T, Tajiri H, Swain CP (2005) Endoscopic full-thickness resection with sutured closure in a porcine model. Gastrointest Endosc 62(1):122–129

    Article  PubMed  Google Scholar 

  8. Desilets DJ, Romanelli JR, Earle DB, Surti VC, Willingham FF, Brugge WR (2009) Loop-anchor purse-string versus endoscopic clips for gastric closure: a natural orifice transluminal endoscopic surgery comparison study using burst pressures. Gastrointest Endosc 70(6):1225–1230

    Article  PubMed  Google Scholar 

  9. von Renteln D, Schmidt A, Riecken B, Caca K (2008) Gastric full-thickness suturing during EMR and for treatment of gastric-wall defects (with video). Gastrointest Endosc 67(4):738–744

    Article  Google Scholar 

  10. Cios TJ, Reavis KM, Renton DR, Hazey JW, Mikami DJ, Narula VK et al (2008) Gastrotomy closure using bioabsorbable plugs in a canine model. Surg Endosc Other Interv Tech 22(4):961–966

    Article  Google Scholar 

  11. von Renteln D, Schmidt A, Vassiliou MC, Gieselmann M, Caca K (2009) Natural orifice transluminalendoscopic surgery gastrotomy closure with an over-the-endoscope clip: a randomized, controlled porcine study (with videos). Gastrointest Endosc 70(4):732–739

    Article  Google Scholar 

  12. Fujishiro M, Yahagi N, Kakushima N, Kodashima S, Muraki Y, Ono S et al (2006) Successful nonsurgical management of perforation complicating endoscopic submucosal dissection of gastrointestinal epithelial neoplasms. Endoscopy 38(10):1001–1006

    Article  CAS  PubMed  Google Scholar 

  13. Matsuda T, Fujii T, Emura F, Kozu T, Saito Y, Ikematsu H et al (2004) Complete closure of a large defect after EMR of a lateral spreading colorectal tumor when using a two-channel colonoscope. Gastrointest Endosc 60(5):836–838

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by State key program of clinical specialty of China.

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    Authors and Affiliations

    1. Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan, China

      An-liu Tang, Xiang-qi Liao, Shou-rong Shen, Ding-hua Xiao, Yun-xiang Yuan & Xiao-yan Wang

    2. Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China

      An-liu Tang, Shou-rong Shen & Xiao-yan Wang

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    1. An-liu Tang
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    2. Xiang-qi Liao
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    3. Shou-rong Shen
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    4. Ding-hua Xiao
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    5. Yun-xiang Yuan
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    6. Xiao-yan Wang
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    Corresponding author

    Correspondence to Xiao-yan Wang.

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    Disclosure

    Dr. An-liu Tang, Miss Xiang-qi Liao, Prof. Shou-rong Shen, Ms. Ding-hua Xiao, Miss Yun-xiang Yuan, and Prof. Xiao-yan Wang have no conflicts of interest or financial ties to disclose.

    Additional information

    An-liu Tang and Xiang-qi Liao have contributed equally to this manuscript.

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    Tang, Al., Liao, Xq., Shen, Sr. et al. Application of clips assisted with foreign body forceps in defect closure after endoscopic full-thickness resection. Surg Endosc 30, 2127–2131 (2016). https://doi.org/10.1007/s00464-015-4414-4

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    • DOI: https://doi.org/10.1007/s00464-015-4414-4

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