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. 2024 Jun 6;12(16):2738-2744.
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  1 , Xiao-Feng Lin  1 , Shu-Ting Wen  1 , Jing-Yi Xu  2 , Zhao-Li Fu  1 , Shu-Min Qin  3
Affiliations

Effect of endoscopic full-thickness resection assisted by distal serosal turnover with floss traction for gastric submucosal masses

Tian-Wen Liu et al. World J Clin Cases. .

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

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Conflict of interest statement

Conflict-of-interest statement: All the authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Schematic diagram of distal serosal inversion with endoscopic full-thickness resection assisted by dental floss traction.
See this image and copyright information in PMC

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