Endoscopic Closure Of Gastric Full-thickness Defects By Application Of Metallic Clips And New Type Endoloop

Objective To study the feasibility and safety of the metallic clips and endoloops for gastric full-thickness defects caused by EFR,and compare the difference of Le Camp TM endoloop and Olympus endoloop.Methods 32 patients with submucosal tumors in gastric fundus were randomly divided into two groups----study group with 14 patients and control group with 18 patients, all patients were treated with endoscopic full-thickness resection.After the operation,metallic clips and Le CampTM endoloops were used to close the gastric defect in the study group, metallic clips and Olympus endoloops were used to close the gastric defects in the control group.The closure success rate、closure time、numbers of metallic clips and endoloops、complications and the wound healing rate were compared.Results All patients underwent endoscopic full-thickness resection.The closure success rate of the two groups were both 100%, the difference was not statistically significant(P > 0.05). The closure time in study group and control group were(13.86±4.62)min and(18.28±6.48)min,the difference was statistically significant( P< 0.05). The numbers of metallic clips in study group and control group were(9.43±4.09) and(9.67±3.61)(P>0.05). The numbers of endoloops in study group and control group were(1.00±0.00)and(1.06±0.24)(P>0.05). The numbers of abdominal puncture and pumping gas in study group and control group were 1 and 2cases in the operations(P >0.05);. Different degrees of pneumoperitoneum were found by the examination of erect abdominal radiograph in 24 hours after the operations, but all patients didn’t need to abdominal puncture and pumping gas because the symptom was not obvious. No subcutaneous emphysema 、 pneumothorax 、 pneumomediastinum was found by the examination of chest radiograph in 24 hours after the operations. No complications such as postoperative bleeding and abdominal infection were found after the operations. All patients were followed up, the wound scars and part of the metallic clips and endoloops were found in 1 month after the operations. The wound healing was satisfactory in 2 month after the operations.The difference of the wound healing rate between the two groups was not statistically significant( P > 0.05).Conclusion The application of metallic clips and new endoloop is safe and effective for the closure of gastric full-thickness defects.