title: Application of novel endoloops to close the defects resulted from endoscopic full-thickness resection with single-channel gastroscope: a multicenter study.
abstract: The key step of the endoscopic full-thickness resection (EFTR) procedure is the successful closure of any gastric wall defect which ultimately avoids surgical intervention. This report presents a new method of closing large gastric defects left after EFTR, using metallic clips and novel endoloops by means of single-channel endoscope.
  
  
  
  We retrospectively analyzed 68 patients who were treated for gastric fundus gastrointestinal stromal tumors originating from the muscularis propria layer at four institutes between April 2014 and February 2015 and consequently underwent EFTR. The large gastric post-EFTR defects were completely closed with metallic clips and novel endoloops using single-channel endoscope, and all the patients were discharged with subsequent endoscopic and clinical follow-up. Patient characteristics, tumor size, en bloc resection rate, closure operation time, and postoperative adverse events were evaluated.
  
  
  
  EFTR was successfully performed on 68 patients [41 male (60 %), 27 female (40 %); median age 61 years, range 38-73], and the en bloc resection rate was 100 %. Complete closure of all the gastric post-EFTR defects was achieved (success rate 100 %). The mean closure operation time was 13 min (range 9-21 min). The mean maximum size of the lesions was 2.6 cm (range 2.0-3.5 cm). One Mallory-Weiss syndrome and one delayed bleeding were resolved with nonsurgical treatment. The wounds were healed in all cases 1 month after the procedure.
  
  
  
  The use of metallic clips and novel endoloops with single-channel endoscope is a relatively safe, easy, and feasible method for repairing large gastric post-EFTR defects.
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, China.
authors.forename: Dongtao
authors.initials: D
authors.lastname: Shi
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, China. lrhcsz@163.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, China.
authors.forename: Weichang
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, China.
authors.forename: Deqing
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, The People's Hospital of Donghai County, Lianyungang, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, The People's Hospital of Donghai County, Lianyungang, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Guo
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Yao
authors.affiliation: Department of Gastroenterology, The First People's Hospital of Yancheng City, Yancheng, China.
authors.forename: Xudong
authors.initials: X
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D005748:Gastric Fundus / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D020699:Gastroscopes; D005773:Gastroscopy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013525:Surgical Instruments; D058106:Wound Closure Techniques / Q000295:instrumentation*
keywords: Defect closure; Endoloop; Endoscopic full-thickness resection; Gastrointestinal stromal tumors