Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.120
Peer-review started: October 31, 2019
First decision: November 13, 2019
Revised: November 26, 2019
Accepted: December 13, 2019
Article in press: December 13, 2019
Published online: January 6, 2020
Processing time: 67 Days and 2.8 Hours
Gastrointestinal stromal tumors (GISTs) originate from interstitial cells of Cajal. GISTs can occur anywhere along the gastrointestinal tract. Large lesions have traditionally been removed surgically. However, with recent innovations in advanced endoscopy, GISTs located within the stomach are now removed endoscopically. We describe a new innovative endoscopic technique to close large and hard to access defects after endoscopic full-thickness resection of gastric GISTs.
We present a series of three patients who were diagnosed with a gastric GIST. All patients underwent full-thickness endoscopic resection. In all cases, for closure of the surgical bed, conventional endoscopic techniques including hemoclips, endoloop and suturing were unsuccessful. We performed a new technique in which we pulled omental fat into the gastric lumen and completely closed the defect using endoscopic devices. All patients performed well post-procedure and computed tomography was carried out one day after the procedures which showed no extravasation of contrast.
The omental plug technique may be used as an alternative to surgery in selected cases of gastric perforation.
Core tip: We present three patients who were diagnosed with gastric gastrointestinal stromal tumors. All patients underwent endoscopic full-thickness resection. We describe a new technique in which the omental fat is pulled into the gastric lumen and clipped to the edges of the defect. Then, continuous endosutures or an endoloop were placed in the surrounding gastric mucosa and cinched leading to complete closure of the defect. This novel closure technique may be an alternative to surgery in selected cases of gastric perforation.