Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430000, Hubei province, China.
World J Gastroenterol. 2024 Mar 7;30(9):1143-1153. doi: 10.3748/wjg.v30.i9.1143.
Endoscopic full-thickness resection (EFTR) of gastric submucosal tumors (SMTs) is safe and effective; however, postoperative wound management is equally important. Literature on suturing following EFTR for large (≥ 3 cm) SMTs is scarce and limited.
To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large (≥ 3 cm) SMTs.
We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University. The operative, postoperative, and follow-up conditions of the patients were evaluated.
All tumors were completely resected using EFTR. 36 (42.35%) patients had tumors located in the fundus of the stomach, and 49 (57.65%) had tumors located in the body of the stomach. All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment. Postoperative fever and stomach pain were reported in 13 (15.29%) and 14 (16.47%) patients, respectively. No serious adverse events occurred during the intraoperative or postoperative periods. A postoperative review of all patients revealed no residual or recurrent lesions.
Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture, especially for large (≥ 3 cm) EFTR wounds in SMTs.
内镜下全层切除术（EFTR）治疗胃黏膜下肿瘤（SMT）安全有效；然而，术后创面处理同样重要。EFTR 治疗直径较大（≥3cm）SMT 后缝合的文献报道较少且有限。
评估双尼龙线荷包缝合法在 EFTR 治疗直径较大（≥3cm）SMT 后闭合创面的疗效和临床价值。
我们回顾性分析了武汉大学人民医院内镜中心成功切除胃底或胃体小弯侧 SMT 后，采用双尼龙线荷包缝合法处理创面的 85 例患者的资料。评估患者的手术、术后和随访情况。
所有肿瘤均采用 EFTR 完全切除。36 例（42.35%）患者肿瘤位于胃底，49 例（57.65%）患者肿瘤位于胃体。所有患者均在 EFTR 后采用双尼龙线缝合，无需腹腔镜辅助或进一步手术治疗。术后 13 例（15.29%）和 14 例（16.47%）患者分别出现发热和胃痛。术中及术后均无严重不良事件发生。所有患者术后复查均未见残留或复发病灶。
双尼龙线荷包缝合法可成功闭合无法用单根尼龙线完全闭合的创面，尤其适用于直径较大（≥3cm）的 SMT EFTR 创面。
