title: The role of hemoclips reinforcement in the ligation-assisted endoscopic enucleation for small GISTs in gastric fundus.
abstract: BACKGROUND
  Endoscopic ultrasonography- (EUS-) assisted band ligation has been proven to be a safe and effective procedure for the treatment of small gastrointestinal stromal tumors (GISTs) apart from the relatively high risk of the postligation perforation of the gastric fundus. The aim of this study is to investigate the efficacy of hemoclip reinforcement in treating small GISTs in the gastric fundus.
  
  
  METHODS
  During a standard endoscopy, a transparent cap attached to the endoscopic tip was placed over the lesion to exert sustained maximal aspiration before a rubber band was released. Once a definite ligation was confirmed by EUS, the tumor was enucleated. Four to 6 hemoclips were placed on the folds around the ligation band to reduce the tension of the ligation site.
  
  
  RESULTS
  The small GISTs were resected completely in 192 patients. Two cases of delayed perforation were found 72 hours after the procedure and successfully treated with an ordinary conservative method.
  
  
  CONCLUSIONS
  Hemoclip-reinforced endoscopic band ligation with systematic follow-up using EUS appears to be a simple and effective technique for the resection of small GISTs in the gastric fundus.
authors.affiliation: The Shengjing Hospital, China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning 110004, China.
authors.forename: Ge
authors.initials: G
authors.lastname: Nan
authors.affiliation: The Shengjing Hospital, China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning 110004, China.
authors.forename: Sun
authors.initials: S
authors.lastname: Siyu
authors.affiliation: The Shengjing Hospital, China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning 110004, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Sheng
authors.affiliation: The Shengjing Hospital, China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning 110004, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Xiang
authors.affiliation: The Shengjing Hospital, China Medical University, No. 36 Sanhao Street, Shenyang, Liaoning 110004, China.
authors.forename: Guo
authors.initials: G
authors.lastname: Jintao
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000295:instrumentation; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005748:Gastric Fundus / Q000473:pathology / Q000601:surgery; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology* / Q000601:surgery*; D020699:Gastroscopes; D016558:Hemostasis, Endoscopic / Q000295:instrumentation*; D006801:Humans; D008026:Ligation / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome