Background and study aim: Successful closure of wall defects is the key procedure following endoscopic full-thickness
resection (EFTR). In this report we describe a new method similar to interrupted suture
to repair gastric defects by means of endoloops and metallic clips.
Patients and methods: We retrospectively analyzed 20 patients who presented at our institute between March
2011 and February 2012 with gastric submucosal tumors and who consequently underwent
EFTR, with the resulting large gastric defects being closed using endoloops and metallic
clips. Tumor characteristics, en bloc resection rates, and postoperative complications
were evaluated in all the patients.
Results: The median age of the 20 patients was 47 years. The mean maximum size of lesions
was 1.47 ± 0.72 cm (range 0.4 – 3 cm). All lesions were diagnosed by endoscopic ultrasound
as tumors in the muscularis propria layer. The en bloc resection rate was 100 %. Five
patients developed fever and complained of slight abdominal pain in the first day
after treatment. No patient had severe complications such as peritonitis or abdominal
abscess. In all cases, wounds healed after 1 month. We observed the persistence of
the clips for over 3 months in 6 out of 19 cases without any clinical manifestations
or large injury to the intestine.
Conclusions: Our study provides evidence that the use of metallic clips and endoloops is a relatively
safe, easy, and feasible method for repairing gastric defects resulting from EFTR.
