Abstract:Objective With the development and maturation of endoscopic resection, endoscopic full-thickness resection (EFTR) derived from endoscopic submucosal dissection (ESD) is gradually accepted and promoted to treat tumors originating from muscularis propria. However, there are some difficulties when EFTR is applied in the treatment of muscularis propria lesions in gastric fundus. This paper intends to explore whether EFTR can be more simple, safe and effective with the traction of dental floss. Methods The clinical data of patients (trial group) with muscularis propria lesions in gastric fundus undergoing EFTR with traction of dental floss from January to December in 2016 in Endoscopy Center, Zhongshan Hospital, Fudan University were reviewed retrospectively. Control group was matched with trial group according to tumor size by one to one from January to December in 2015. The differences in tumor resection time, patient hospitalization time and complication rate were evaluated. Results There was no significant difference in the average age of the two groups with 24 cases respectively (58.7 + 11.8 y vs 56.6 + 7.9 y, t = 0.663, P = 0.511). The statistic difference occurred when tumor resection time was compared in two groups (10.8 + 2.8 min vs 19.0 + 4.7 min, t = 7.298, P <0.05). There was no statistically significant difference in postoperative hospital stay time (3.2 + 0.5 d vs 3.2 + 0.5 d, t = 0.291, P = 0.772). In the trial group, there were 19 cases of gastrointestinal stromal tumors (both Group1) and 5 cases of leiomyoma. The control group have the same result. Two groups of patients were all not happened to postoperative delayed bleeding or perforation and other complications. Conclusion When we performed EFTR to treat tumors originating from muscularis propria in gastric fundus, floss assisted traction can relieve the tumor boundary, so that the surgical level may be clearer to simplify the operation and reduce the tumor resection time.
