Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2024; 12(16): 2738-2744
Published online Jun 6, 2024. doi: 10.12998/wjcc.v12.i16.2738
Effect of endoscopic full-thickness resection assisted by distal serosal turnover with floss traction for gastric submucosal masses
Tian-Wen Liu, Xiao-Feng Lin, Shu-Ting Wen, Jing-Yi Xu, Zhao-Li Fu, Shu-Min Qin
Tian-Wen Liu, Xiao-Feng Lin, Shu-Ting Wen, Zhao-Li Fu, Shu-Min Qin, Department of Gastroenterology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Jing-Yi Xu, The Second Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
Co-first authors: Tian-Wen Liu and Xiao-Feng Lin.
Author contributions: Liu TW and Lin XF contributed equally to this work as co-first authors; Qin SM and Liu TW designed this study and wrote the manuscript; Qin SM, Lin XF, Wen ST and Xu JY participated in collection and analysis of data; Qin SM, Fu ZL and Liu TW reviewed and revised the manuscript. All authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by Ethics Committee of Guangdong Provincial Hospital of Chinese Medicine (Approval No. ZE2023-220-01).
Informed consent statement: Consent was not needed as the study was retrospective without exposure to the patients’ data.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shu-Min Qin, MD, PhD, Associate Research Fellow, Department of Gastroenterology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 55 Neihuanxi Road, Panyu District, Guangzhou 510006, Guangdong Province, China. shuminqin@gzucm.edu.cn
Received: January 12, 2024
Revised: April 8, 2024
Accepted: April 16, 2024
Published online: June 6, 2024
Processing time: 137 Days and 23.6 Hours
Abstract
BACKGROUND

Complex and high-risk surgical complications pose pressing challenges in the clinical implementation and advancement of endoscopic full-thickness resection (EFTR). Successful perforation repair under endoscopy, thereby avoiding surgical intervention and postoperative complications such as peritonitis, are pivotal for effective EFTR.

AIM

To investigate the effectiveness and safety of EFTR assisted by distal serosal inversion under floss traction in gastric submucosal tumors.

METHODS

A retrospective analysis of patients with gastric and duodenal submucosal tumors treated with EFTR assisted by the distal serosa inversion under dental floss traction from January 2023 to January 2024 was conducted. The total operation time, tumor dissection time, wound closure time, intraoperative bleeding volume, length of hospital stay and incidence of complications were analyzed.

RESULTS

There were 93 patients, aged 55.1 ± 12.1 years. Complete tumor resection was achieved in all cases, resulting in a 100% success rate. The average total operation time was 67.4 ± 27.0 min, with tumor dissection taking 43.6 ± 20.4 min. Wound closure times varied, with gastric body closure time of 24.5 ± 14.1 min and gastric fundus closure time of 16.6 ± 8.7 min, showing a significant difference (P < 0.05). Intraoperative blood loss was 2.3 ± 4.0 mL, and average length of hospital stay was 5.7 ± 1.9 d. There was no secondary perforation after suturing in all cases. The incidence of delayed bleeding was 2.2%, and the incidence of abdominal infection was 3.2%. No patient required other surgical intervention during and after the operation.

CONCLUSION

Distal serosal inversion under dental-floss-assisted EFTR significantly reduced wound closure time and intraoperative blood loss, making it a viable approach for gastric submucosal tumors.

Keywords: Endoscopic full-thickness resection; Serosa inversion; Dental floss traction; Gastric submucosal tumor; Auxiliary technology

Core Tip: In a comprehensive study of 93 patients diagnosed with gastric and duodenal submucosal tumors, who underwent endoscopic full-thickness resection facilitated by distal serosa inversion under dental floss traction, we observed a significant reduction in wound closure time and intraoperative bleeding volume. This approach demonstrated feasibility and has potential for wider application and adoption due to its demonstrated benefits.