Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2024; 30(9): 1143-1153
Published online Mar 7, 2024. doi: 10.3748/wjg.v30.i9.1143
Double-nylon purse-string suture in closing postoperative wounds following endoscopic resection of large (≥ 3 cm) gastric submucosal tumors
Shan-Shan Wang, Meng-Yao Ji, Xu Huang, Yan-Xia Li, Shi-Jie Yu, Yu Zhao, Lei Shen
Shan-Shan Wang, Meng-Yao Ji, Xu Huang, Yan-Xia Li, Shi-Jie Yu, Yu Zhao, Lei Shen, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430000, Hubei province, China
Co-first authors: Shan-Shan Wang and Meng-Yao Ji.
Author contributions: Shen L proposed the conception and design of the research content; The surgery was performed by Shen L; Wang SS, Ji MY, Huang X, Li YX, Yu SJ and Zhao Y for postoperative observation and management of patients; Wang SS and Ji MY completed data collection and analysis and article writing; Shen L critically revised the important knowledge content of the article; Shen L gives final approval to the article.
Institutional review board statement: This observational study was approved by the Ethics Committee of Renmin Hospital of Wuhan University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: Lei Shen, PhD, Chief Doctor, Department of Gastroenterology, Renmin Hospital of Wuhan University, No. 99 Jiefang Road, Wuchang District, Wuhan 430000, Hubei Province, China. szggyx@163.com
Received: December 1, 2023
Peer-review started: December 1, 2023
First decision: January 4, 2024
Revised: January 4, 2024
Accepted: February 2, 2024
Article in press: February 2, 2024
Published online: March 7, 2024
Abstract
BACKGROUND

Endoscopic full-thickness resection (EFTR) of gastric submucosal tumors (SMTs) is safe and effective; however, postoperative wound management is equally important. Literature on suturing following EFTR for large (≥ 3 cm) SMTs is scarce and limited.

AIM

To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large (≥ 3 cm) SMTs.

METHODS

We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University. The operative, postoperative, and follow-up conditions of the patients were evaluated.

RESULTS

All tumors were completely resected using EFTR. 36 (42.35%) patients had tumors located in the fundus of the stomach, and 49 (57.65%) had tumors located in the body of the stomach. All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment. Postoperative fever and stomach pain were reported in 13 (15.29%) and 14 (16.47%) patients, respectively. No serious adverse events occurred during the intraoperative or postoperative periods. A postoperative review of all patients revealed no residual or recurrent lesions.

CONCLUSION

Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture, especially for large (≥ 3 cm) EFTR wounds in SMTs.

Keywords: Endoscopic full-thickness resection, Purse-string suture, Postoperative wounds, Submucosal tumors

Core Tip: This study aimed to evaluate the clinical value of double-nylon purse-string sutures in closing gastric defects following submucosal tumor treatment with endoscopic full-thickness resection. Findings revealed that gastric wall defects were successfully closed using double-nylon purse-string sutures in patients with a tumor (≥ 3 cm), without laparoscopic assistance or need for further surgical treatment. There was also no recurrence or residue of lesions in all participants. We believe that our study makes a significant contribution to the literature because it evaluates the safety and short-term efficacy of a novel closure method in gastrointestinal endoscopy.