Evaluation of the dual-action tissue closure device for perforation closure after endoscopic full-thickness resection of gastric submucosal tumors >10 mm.

BACKGROUND

Endoscopic full-thickness resection (EFTR) is an effective technique for endoscopic resection of gastric submucosal tumors (G-SMTs); however, the closure of the post-operative perforation wound presents a significant challenge. We invented a dual action tissue closure device (DAT), and aimed to evaluate its feasibility and safety in closing perforation wounds following EFTR of G-SMTs.

METHODS

This is a retrospective study that included the data of patients who underwent EFTR for G-SMTs at Nanfang Hospital (Guangzhou, China) between 1 January 2021 and 1 April 2024. All these wounds were closed using the DAT and through-the-scope clip. The collected data included tumor size and location, total procedure time, closure success rate, closure time, complications, and follow-up outcomes. The closure efficacy of the DAT was evaluated accordingly.

RESULTS

Twenty-nine patients (median age, 57 years old, 37.9% women) completed EFTR of G-SMTs, which included 2 cases utilizing cap-assisted full-thickness resection and 27 cases using EFTR. The tumors had a median long diameter of 20 (15-30) mm and short diameter of 15 (10-25) mm. All wounds were successfully closed without complications. The median total operation time was 55 minutes (interquartile range: 33.5-70.0 minutes), and the median wound closure time was 19 minutes (range: 12.0-27.0 minutes). The median number of DAT used was 1 (interquartile range: 1-3), with a median operation time of 3 minutes (1.6-6.5) for per DAT. Seven patients underwent endoscopic follow-up, with 88.2% of the DATs falling off naturally.

CONCLUSIONS

DAT can effectively and safely close perforation wounds following EFTR of G-SMTs.