Researchers from China developed a new endoscopic closure technique to repair gastric wall defects after endoscopic full-thickness resection (EFTR) performed to treat gastrointestinal stromal tumors (GISTs).

“The described endoscopic loop ligation technique is feasible, effective, and safe for repairing gastric wall defects after EFTR for gastric submucosal tumors originating from the muscularis propria layer,” they wrote in an article published in the Scandinavian Journal of Gastroenterology.

In order to assess the safety and clinical efficacy of the new technique, the team led by Guang Yu from Taizhou Municipal Hospital in Zhejiang, China enrolled 21 patients with gastric submucosal tumors between December 2016 and December 2019. Of these, 15 had tumors in the fundus of the stomach and 6 had tumors in the upper body of the stomach. All tumors were removed with EFTR and the defects in the gastric wall were repaired using the new technique. 

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The average time it took for the closure to be completed was 9 minutes and the average hospitalization time was 5 days. 

No delayed bleeding, gastrointestinal fistula following the operation, or abdominal infection occurred. No patient had to have repeat surgery. No residual or recurrent tumors were recorded in the 6- to 24-month follow-up period.

Only 1 patient experienced abdominal pain and increased temperature 1 day after surgery. He was given anti-infection, antacid, and gastrointestinal decompression treatments and discharged after 4 days.

The researchers concluded that the application of the novel technique is “effective, simple, and easy” greatly shortening the operation time. Because the materials used during the procedure are cheap, the cost per patient is greatly reduced, they said. However, they added that the sample size in this study was small and more research with a larger number of patients is necessary to verify the safety and efficacy of the new approach.


Wang G, Xiang Y, Miao Y, Wang H, Xu M, Yu G. The application of endoscopic loop ligation in defect repair following endoscopic full-thickness resection of gastric submucosal tumors originating from the muscularis propria layer. Scand J Gastroenterol. 2021;2:1-5. doi:10.1080/00365521.2021.1981994