Li Jun, Hou Xiaojia, Chen Kan, Peng Kangsheng, Huang Chao, Liu Feng
Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Shanghai, China.
Department of Gastroenterology, Shanghai Tenth People's Hospital, Shanghai, China.
Endosc Int Open. 2025 Jun 12;13:a25442572. doi: 10.1055/a-2544-2572. eCollection 2025.
Effective tissue traction is crucial for gastric endoscopic full-thickness resection (EFTR) to ensure a clear visual field for the dissection site. We aimed to evaluate the effectiveness of internal traction using a novel clip-with-spring device in assisting gastric EFTR.
Twenty-six patients with gastric subepithelial lesions from the muscularis propria were enrolled for internal traction-assisted EFTR (IT-EFTR) and 26 patients for non-assisted EFTR (NA-EFTR) were enrolled as controls.
Average tumor size was 1.5 ± 0.4 cm. All EFTRs were completed successfully with an average total procedure time of 62.4 ± 43.0 minutes and perforation time of 37.2 ± 29.9 minutes. En bloc resection was achieved in 50 patients (96.2%). IT-EFTR significantly improved serosa exposure score (3.4 ± 0.9 vs. 1.9 ± 0.7, <0.001) and shortened total procedure time (33.0 ± 21.8 vs. 91.8 ± 38.6 min, <0.001) and perforation time (19.0 ± 18.8 vs. 55.5 ± 27.8 min, <0.001) compared with NA-EFTR. There were no significant differences in complication rates between the two groups. However, visual analogue score after the procedure was significantly lower (4.2 ± 1.0 vs. 4.7 ± 0.7, =0.037) and postoperative hospital stay (3.7 ± 2.1 vs. 4.8 ± 1.3, =0.038) was significantly shorter in the IT-ERTR group than in the NA-EFTR group.
Internal traction using the novel clip-with-spring device could significantly improve safety and efficacy of gastric EFTR in the distal stomach.
有效的组织牵引对于胃内镜全层切除术（EFTR）至关重要，以确保切除部位有清晰的视野。我们旨在评估使用新型带弹簧夹装置进行内部牵引辅助胃EFTR的有效性。
纳入26例来自固有肌层的胃黏膜下病变患者进行内部牵引辅助EFTR（IT-EFTR），并纳入26例未进行辅助EFTR（NA-EFTR）的患者作为对照。
平均肿瘤大小为1.5±0.4 cm。所有EFTR均成功完成，平均总手术时间为62.4±43.0分钟，穿孔时间为37.2±29.9分钟。50例患者（96.2%）实现整块切除。与NA-EFTR相比，IT-EFTR显著改善了浆膜暴露评分（3.4±0.9对1.9±0.7，<0.001），缩短了总手术时间（33.0±21.8对91.8±38.6分钟，<0.001）和穿孔时间（19.0±18.8对55.5±27.8分钟，<0.001）。两组并发症发生率无显著差异。然而，IT-EFTR组术后视觉模拟评分显著更低（4.2±1.0对4.7±0.7，=0.037），术后住院时间（3.7±2.1对4.8±1.3，=0.038）显著短于NA-EFTR组。
使用新型带弹簧夹装置进行内部牵引可显著提高远端胃EFTR的安全性和有效性。
