Endoscopic Hand Suturing in the Prevention of Gastrointestinal Bleeding After Gastric Endoscopic Submucosal Dissection.

Jagiellonian University

Status: Completed

Conditions: Endoscopic Surgical Procedures

Treatments: Procedure: Clipping; Procedure: Suturing; Procedure: No closure

Study type: Observational

Funder types: Other

Identifiers

NCT06779266

2025-0101

Details and patient eligibility

About

Endoscopic hand-suturing (EHS) is a significant improvement in gastrointestinal advanced endoscopic procedures. Evidence supporting its effectiveness in clinical practice is limited due to its recent introduction and limited availability. This study aims to demonstrate the feasibility of EHS following advanced endoscopic submucosal dissection (ESD) in the stomach and investigate its potential to prevent gastrointestinal bleeding.

Full description

Endoscopic hand-suturing (EHS) is a significant improvement in gastrointestinal advanced endoscopic procedures. Evidence supporting its effectiveness in clinical practice is limited due to its recent introduction and limited availability. This study aims to demonstrate the feasibility of EHS following advanced endoscopic submucosal dissection (ESD) in the stomach and investigate its potential to prevent gastrointestinal bleeding. The retrospective single-center study included individuals who underwent endoscopic submucosal dissection in the stomach. The resection site was either left open, clipped, or sutured. The study evaluated the overall procedure time (OPT), bleeding rate (BR), perforation rate, and length of hospital stay (HS). The assessment was conducted to compare the outcomes of "non-sutured vs. sutured" "no closure vs. closure" and "clipped vs. sutured" along with the propensity score matching analysis for reducing a potential selection bias.

Enrollment: 179 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• underwent gastric ESD from June 2015 to June 2024
• Eastern Cooperative Oncology Group performance status score of 0 or 1

Exclusion criteria

• none

Trial design

179 participants in 3 patient groups

No closure

Description:

Participants who underwent endoscopic submucosal dissection without additional closure of the resection site.

Treatment:

Procedure: No closure

Sutured

Description:

Participants who underwent endoscopic submucosal dissection followed by closure of the resection site with through-the-scope suturing.

Treatment:

Procedure: Suturing

Clipped

Description:

Participants who underwent endoscopic submucosal dissection followed by closure of the resection site with through-the-scope clips.

Treatment:

Procedure: Clipping