Endoscopic full-thickness resection with sutured closure in a porcine model.
BACKGROUND
Some early gastric cancers might be advantageously staged and treated by full-thickness resection if secure methods for closing the defect were available. The aim of this study was to test the feasibility of full-thickness gastric resection.


METHODS
Full-thickness gastric resections were performed by using a ligating device without submucosal injection in survival studies in pigs (n = 8). The defects were closed by using new methods for suturing, locking, and cutting thread through a 2.8-mm accessory channel. Stitches (n = 2-4) were placed close to the target area before resection.


METHODS
Full-thickness resections (n = 8) were performed. The pigs survived without incident for 21 to 28 days. Healing of the suture site was evident at follow-up endoscopy. Suture sites were water tight. The pull-out force with stitches by using this new sewing method was significantly higher than with endoscopic clips (20.3 N +/- 0.94 vs. 2.2 N +/- 0.42, p < 0.05).


CONCLUSIONS
Endoscopic full-thickness resection with sutured defect closure was feasible and appeared safe in these survival experiments.
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
Keiichi
K
Ikeda
Annette
A
Fritscher-Ravens
C Alexander
CA
Mosse
Tim
T
Mills
Hisao
H
Tajiri
C Paul
CP
Swain
D000818:Animals; D004867:Equipment Design; D004869:Equipment Safety; D005240:Feasibility Studies; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods* / Q000401:mortality; D005773:Gastroscopy; D013270:Stomach / Q000166:cytology / Q000601:surgery*; D015996:Survival Rate; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D013552:Swine