OVERSTITCH SUTURE OF PARIETAL DEFECTS AFTER ESD AND EFTR IS FEASIBLE, SAFE AND REDUCE THE NEED FOR HOSPITALIZATION

Aims Endoscopic submucosal dissection (ESD) and endoscopic full thickness resection (eFTR) are recognized as valid advanced techniques for the treatment of pre-neoplastic and neoplastic lesions of the gastrointestinal tract.

However, complication rate and need of hospitalization still remain a matter of discussion.

The application of suturing devices have been suggested as an option to prevent complications and reduce hospital stay.

The aim of our study was to analyse the feasibility and safety of Overstitch suturing devices applied after large and deep ESD/eFTR. The secondary aim was to evaluate the efficacy of suturing system to reduce hospital stay and complication rate.

Methods From September 2020 to November 2021(in Covid-19 pandemic era) all consecutive patients sutured with Apollo SX Overstich after complex resection were prospectively enrolled. Feasibility, complications, hospital stay were analyzed.

Results Fourteen patients (6 female, mean 79+-8 yo) were enrolled; lesions were located in the stomach (3), in the rectum (7), in the sigmoid colon (2), in the descending colon (2). Final diagnosis were 10 HGD/T1(sm1) and 4 lesions T1 (sm2/3) or T2 colo-rectal cancer. Eight were treated with ESD as outpatients whereas 4 underwent an eFTR as inpatients with uneventful medium hospital stay of 4.7 days(range 4-6).

Overstich suture was feasible in all the lesions and all locations. No major complications occurred. One minor complications (colonic luminal stenosis) occurred and was successfully treated with placement of covered metal stent.

Fig. 1

Conclusions Endoscopic overstitch system is feasible, safe and a useful tool to close large or deep wall defect after ESD/eFTR, avoiding unnecessary hospitalization.

Publication History

Article published online:
14 April 2022