Comparison between interrupted closure technique and traditional closure technique in endoscopic full-thickness resection for treating gastric subepithelial lesions.

BACKGROUND

Gastric subepithelial lesions (SELs) are elevated lesions originating from the muscularis mucosa, submucosa, or muscularis propria, and may also include extraluminal lesions. For small SELs (less than 5 cm), complete endoscopic excision is the preferred treatment. Endoscopic full-thickness resection (EFTR) has proven to be an effective approach.

AIM

To evaluate the efficacy of the interrupted closure technique compared to the traditional closure technique in EFTR for gastric SELs.

METHODS

This single-center, prospective, randomized controlled trial was conducted at a tertiary hospital from September 2023 to September 2024. A total of 90 patients who underwent EFTR for gastric SELs were randomly allocated to either the interrupted closure group ( = 44) or the traditional closure group ( = 46).

RESULTS

All patients had complete resection and wound closure without any severe postoperative complications. The incidence of intraoperative gas-related complications was significantly lower in the interrupted closure group than in the traditional closure group (2.27% 26.09%, = 0.001), demonstrating interrupted closure technique can reduce the incidence of gas-related issues. Statistical analysis revealed that the incidence of postoperative infection was significantly lower in the experimental group than in the control group (15.91% 41.30%, = 0.008). Additionally, the median duration of antibiotic use was lower in the experimental group (3.5 days 5 days, = 0.013). Abdominal pain levels on postoperative days 1 and 4 were also lower in the experimental group compared to the control group ( < 0.001).

CONCLUSION

The interrupted closure technique in EFTR for treating gastric SELs is safe and effective, reducing the incidence of intraoperative gas complications and postoperative infections.