Year 2025 / Volume 117 / Number 3
Letter
Preserved mucosa unroofing facilitated closure of a large gastric defect after endoscopic full-thickness resection

162-163

DOI: 10.17235/reed.2024.10379/2024

Kaisheng Zhang, Xue Xiao, Xianfei Zhong, Yu Tang,

Abstract
A 58-year-old woman was found to have a submucosal bulging lesion in the anterior wall of the gastric fundus during a screening esophagogastroscopy. Endosonographic evaluation revealed it to be a 3.1×2.5cm, hypoechoic mass originating from muscularis propria (MP). Endoscopic full-thickness resection (EFR) was attempted. After submucosal injection, a four-fifth circumferential mucosal incision was made around the lesion. Submucosal dissection was performed to unroof the overlying mucosa, which was preserved via the remaining one-fifth circumferential mucosal edge. Thus a mucosal flap was created and turned aside to expose the mass. En bloc resection of the lesion resulted in a 3.5*3.0cm full-thickness defect . The mucosal flap was flipped back and the defect was almost fully covered. Therefore, closure of the defect was accomplished by simply clipping the two edges of the initially incised mucosa. The patient was discharged 2 days later without discomfort. Histopathology confirmed a gastrointestinal stromal tumor (GIST), prognostic group 1.
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References
WHO Classification of Tumours Editorial Board. WHO Classification of Tumours of the Digestive System. 5th ed, Vol. 1. Lyon: IARC, 2019.
Zhou PH, Yao LQ, Qin XY, et al. Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc 2021;25:2926-2931.
Fu M, Dong T, He K, et al. Snare traction-assisted method during endoscopic resection for gastric submucosal tumors: a single center case series. Rev Esp Enferm Dig 2023 Nov 6. doi:10.17235/reed.2023.10034/2023.Epub ahead of print.
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Zhang K, Xiao X, Zhong X, Tang Y. Preserved mucosa unroofing facilitated closure of a large gastric defect after endoscopic full-thickness resection . 10379/2024


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Publication history

Received: 02/03/2024

Accepted: 06/03/2024

Online First: 12/03/2024

Published: 06/03/2025

Article Online First time: 10 days

Article editing time: 369 days


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