title: Complete closure of large gastric defects after endoscopic full-thickness resection, using endoloop and metallic clip interrupted suture.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Shi
authors.forename: T
authors.initials: T
authors.lastname: Chen
authors.forename: Y-S
authors.initials: YS
authors.lastname: Zhong
authors.forename: P-H
authors.initials: PH
authors.lastname: Zhou
authors.forename: Z
authors.initials: Z
authors.lastname: Ren
authors.forename: M-D
authors.initials: MD
authors.lastname: Xu
authors.forename: L-Q
authors.initials: LQ
authors.lastname: Yao
mesh_terms: D000328:Adult; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*; D013274:Stomach Neoplasms / Q000601:surgery*; D013525:Surgical Instruments; D013536:Suture Techniques / Q000295:instrumentation