Clinical application of single forcep endoscopic purse-string suture closing the wound of cardia and gastric fundus after endoscopic full-thickness resection for patients with submucosal tumor(with video)

Objective To evaluate the efficacy and safety of single forcep endoscopic purse-string suture closing the wound of cardia and gastric fundus after endoscopic full-thickness resection (EFTR) for patients with submucosal tumor (SMT). Methods The clinical data of 32 patients with wound in the cardia and gastric fundus after EFTR for SMT undergoing single forcep endoscopic purse-string suture in Endoscopy Center of Renmin Hospital of Wuhan University from January 2015 to January 2016 were collected. Completion of operation, postoperative complication and follow-up results of these patients were retrospectively analyzed. Results All of the patients successfully received EFTR and purse-string suture. The maximal diameter of tumors was 1-4 cm. The suture time was 10-15 min, and postoperative hospital stay was 5-10 d. Low fever and upper abdominal pain were found in 13 and 20 cases respectively, and all cases were alleviated or restored after conservative treatment. All patients underwent gastroscopy during follow-up of 1 month, and titanium clip and nylon rope were found on the wound surface in 29 cases (90.6%). Three months after operation, 28 patients underwent gastroscopy, and titanium clip but no nylon rope was detected in 15 cases (46.9%). Conclusion Single forcep endoscopic purse-string suture can effectively treat the postoperative wound in the cardia and gastric fundus of patients with submucosal tumors after EFTR. Key words: Therapeutic endoscopy; Endoscopic purse-string suture; Endoscopic full-thickness resection; Submucosal tumor