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Efficacy of mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection

World Journal of Gastrointestinal Endoscopy 2020年第1期12卷 17-22页

作者： Satoshi Kinoshita Toshihiro Nishizawa Ai Fujimoto Hideki Mori Yoshihiro Nakazato Masahiro Kikuchi Toshio Uraoka Department of Gastroenterology National Hospital Organization Tokyo Medical CenterTokyo 152-8902Japan Division of Research and Development for Minimally Invasive Treatment Cancer CenterKeio University School of MedicineTokyo 160-8582Japan Department of Gastroenterology and Hepatology International University of Health and Welfare Mita HospitalTokyo 108-8329Japan Department of Internal Medicine Division of Gastroenterology and HepatologyGunma UniversityMaebashi 371-8511Japan

BACKGROUND We recently developed a new endoscopic closure technique using only conventional endo-clips for colorectal *** is known about the feasibility of the endoscopic mucosa-submucosa clip closure method for gastric *** To elucidate the efficacy of the endoscopic mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection(ESD).methodS Twenty-two patients who underwent gastric ESD and mucosa-submucosa clip closure were included in this *** this method,endo-clips are placed at the edges of a mucosal *** endo-clips are then applied in the same way to facilitate reduction of the defect *** endo-clips are applied to both sides of the mucosal *** closure can be *** have also developed a“location score”and“closure difficulty index”for assessment *** Complete closure was achieved in 68.2%of the patients(15/22).The location score in the failure group was significantly larger than that in the complete closure group(P=0.023).The closure difficulty index in the failure group was significantly higher than that in the complete closure group(P=0.007).When the cutoff value of the closure difficulty index was set at 99,the high closure difficulty index predicted failure with a sensitivity of 57.1%,specificity of 100%,and accuracy of 86.3%.CONCLUSION The endoscopic mucosa-submucosa clip closure method was unreliable after gastric ESD,especially in cases with a high closure difficulty index.

关键词： endoscopic submucosal dissection Stomach endoscopic mucosa-submucosa clip closure method Colorectal

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