Back to Search
Start Over
A novel grasp-and-loop closure method for defect closure after endoscopic full-thickness resection (with video)
- Source :
- Surgical Endoscopy. 31:4275-4282
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Endoscopic full-thickness resection (EFTR) is a minimally invasive method for en bloc resection of gastrointestinal (GI) lesions originating from the muscularis propria layer. Successful closure of the wall defect is a critical step.The aim of this study was to evaluate the feasibility and efficacy of a novel and simplified endoscopic grasp-and-loop (GAL) closure method using an endo-loop assisted with grasping forceps for defect closure.From January 2015 to March 2016, 13 patients with submucosal tumors (SMTs) originating from the muscularis propria (MP) layer underwent EFTR and were enrolled in this study. After successful tumor resection, an endo-loop was anchored onto the circumferential margin of the gastric defect with grasping forceps assistance and tightened gently. Patient characteristics, tumor size, en bloc resection, and postoperative complications were evaluated.Of the 13 lesions in the stomach, two were located in the greater curvature of the mid-upper body, 11 were located in the fundus. The endoscopic GAL closure method was successfully performed after EFTR in all the 13 patients without laparoscopic assistance. The mean procedure time was 43.5 min (range 20-80 min), while the GAL closure procedure took a mean of 9.4 min (range 3-18 min). The mean resected lesion size was 1.5 cm (range 0.5-3.5 cm). Pathological diagnoses of these lesions were 11 gastrointestinal stromal tumors (GISTs) and two leiomyomas. No major adverse events occurred during or after the procedure. All the patients were discharged after a mean time of 2.4 days (range 1-4 days). No residual lesion or tumor recurrence was found during the follow-up period (median, 5 months; range, 1-15 months).The endoscopic GAL closure method is feasible, effective, and safe for closing the gastric defect after EFTR in patients.
- Subjects :
- Adult
Male
medicine.medical_specialty
Endoscopic Mucosal Resection
Gastrointestinal Stromal Tumors
Operative Time
Closure (topology)
Endoscopic mucosal resection
Resection
03 medical and health sciences
Defect closure
0302 clinical medicine
Stomach Neoplasms
medicine
Humans
Full thickness resection
Aged
Leiomyoma
business.industry
En bloc resection
Middle Aged
Surgery
Loop closure
030220 oncology & carcinogenesis
Feasibility Studies
Operative time
Female
030211 gastroenterology & hepatology
business
Subjects
Details
- ISSN :
- 14322218 and 09302794
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Surgical Endoscopy
- Accession number :
- edsair.doi.dedup.....b222eae03e1d50da233bdbc4aba8d203