Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2023; 15(8): 1831-1837
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1831
Outpatient hybrid endoscopic submucosal dissection with SOUTEN for early gastric cancer, followed by endoscopic suturing of the mucosal defect: A case report
Renma Ito, Kazuhiro Miwa, Yutaka Matano
Renma Ito, Kazuhiro Miwa, Yutaka Matano, Internal Medicine, Komatsu Municipal Hospital, Komatsu 923-0961, Japan
Author contributions: Ito R, Miwa K, and Matano Y conceived the idea of the treatment in this case; Ito R drafted the original manuscript; all authors reviewed the manuscript draft and revised it critically.
Informed consent statement: Informed consent for inclusion in the study or equivalent was obtained from the patient’s family.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Renma Ito, MD, Chief Doctor, Internal Medicine, Komatsu Municipal Hospital, 60 Mukaimotoorimachi-ho, Komatsu 923-0961, Japan. remma0504@outlook.jp
Received: May 7, 2023
Peer-review started: May 7, 2023
First decision: June 1, 2023
Revised: June 13, 2023
Accepted: June 27, 2023
Article in press: June 27, 2023
Published online: August 27, 2023
Abstract
BACKGROUND

Although endoscopic submucosal dissection (ESD) is becoming more common for early gastric cancer, it requires more advanced techniques and a longer treatment duration than endoscopic mucosal resection. Hybrid ESD using a multifunctional snare (SOUTEN) has been reported to be effective for colorectal lesions, as it can reduce treatment duration. Endoscopic suturing of post-ESD mucosal defects has been reported to reduce the incidence of ESD-related complications.

CASE SUMMARY

This study reports outpatient hybrid ESD for early gastric cancer using SOUTEN, followed by endoscopic suturing of post-ESD mucosal defects in an 86-year-old man. On referral for ESD, a 10-mm flat, depressed lesion was found on the posterior wall of the gastric antrum, the depth of which was expected to be mucosal. Given his history of delirium, we performed outpatient endoscopic treatment. The procedure used was hybrid ESD using SOUTEN to reduce the duration of treatment and endoscopic suturing of post-ESD mucosal ESD defects to reduce complications. The procedure time was 62 min and the lesion was completely resected based on histopathological examination, with no reported postoperative complications.

CONCLUSION

This safe and useful procedure may be especially important for outpatient endoscopic treatment.

Keywords: Outpatient treatment, Hybrid endoscopic submucosal dissection, Multifunctional snare, Early gastric cancer, Endoscopic suturing, Case report

Core Tip: Hybrid endoscopic submucosal dissection (ESD) using a multifunctional snare (SOUTEN) has been reported to be effective in reducing treatment duration, and endoscopic suturing of post-ESD mucosal defects has been reported to reduce complications. Herein, we report an outpatient hybrid ESD for early gastric cancer using SOUTEN, followed by endoscopic suturing of post-ESD mucosal defects in an 86-year-old male. The procedure time was 62 min and the lesion was completely resected based on histopathological examination, with no reported postoperative complications.