title: Application of clips assisted with foreign body forceps in defect closure after endoscopic full-thickness resection.
abstract: This study was designed to evaluate the feasibility and efficacy of metallic clips assisted with foreign body forceps closing the gastric wall defect after endoscopic full-thickness resection (EFR) for gastric submucosal tumors (SMTs).
  
  
  
  Eighteen patients with gastric SMTs originated from the muscularis propria were treated by EFR between September 2012 and June 2014. Twelve patients underwent endoscopic closure of the gastric wall defects after EFR with endoloop and metallic clips (endoloop string suture method, ESSM), and six patients with clips and foreign body forceps (clips assisted with foreign body forceps clip method, CFCM).
  
  
  
  No significant differences existed between the two groups in terms of demographics, clinical characteristics, and the size of the gastric wall defects. The average time spent in closing the gastric wall defects (14.83 ± 1.94 min for the CFCM group and 22.42 ± 5.73 min for the ESSM group) and hospitalization fees of the CFCM group were significantly lower than those of the ESSM group. The average hospitalization time of the two groups had no statistical significance. No single case had surgical intervention or complications, such as gastric bleeding, perforation, peritonitis, or abdominal abscess.
  
  
  
  The CFCM and the ESSM are safe and effective techniques for gastric defect closure after EFR for gastric SMTs. Because of the "chopsticks effect," the CFCM more suitable for the lesions located at the gastric fundus, the greater curvature or anterior wall of the gastric body and gastric antrum.
authors.affiliation: Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan, China.|Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China.
authors.forename: An-Liu
authors.initials: AL
authors.lastname: Tang
authors.affiliation: Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan, China.
authors.forename: Xiang-Qi
authors.initials: XQ
authors.lastname: Liao
authors.affiliation: Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan, China.|Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China.
authors.forename: Shou-Rong
authors.initials: SR
authors.lastname: Shen
authors.affiliation: Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan, China.
authors.forename: Ding-Hua
authors.initials: DH
authors.lastname: Xiao
authors.affiliation: Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan, China.
authors.forename: Yun-Xiang
authors.initials: YX
authors.lastname: Yuan
authors.affiliation: Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan, China. wxy20011@163.com.|Hunan Key Laboratory of Nonresolving Inflammation and Cancer, Central South University, Changsha, Hunan, China. wxy20011@163.com.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Wang
mesh_terms: D000069916:Endoscopic Mucosal Resection; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005547:Foreign Bodies / Q000601:surgery; D005773:Gastroscopy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000601:surgery; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013525:Surgical Instruments; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Clips assisted with foreign body forceps clip method (CFCM); Defect closure; Endoloop string suture method (ESSM); Endoscopic full-thickness resection (EFR); Gastric submucosal tumor (SMT)