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        Closing the Gaps: Endoscopic Suturing for Large Submucosal and Full-Thickness Defects

        Keshav Kukreja,Suma Chennubhotla,Bharat Bhandari,Ankit Arora,Shashideep Singhal 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.4

        This article is a systematic review of relevant literature on endoscopic suturing as a primary closure technique for large submucosaland full-thickness defects after endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and endoscopic fullthicknessresection (EFTR). A comprehensive literature search was conducted through 2016 by using PubMed, to find peer-reviewedoriginal articles. The specific factors considered were the procedural indications and details, success rates, clinical outcomes includingcomplications, and study limitations. Six original articles were included in the final review: two with non-human subjects and fourwith human subjects. The mean success rate of endoscopic suturing was 97.4% (100% for human subjects and 95.4% for non-humansubjects). The procedural time ranged from 7 to 89 min. The average size and depth of lesions were 2.71 cm (3.74 cm [human] and1.96 cm [non-human]) and 1.52 cm, respectively. The technique itself had no reported impact on mortality. In conclusion, endoscopicsuturing is a minimally invasive technique for the primary closure of defects caused by EMR, ESD, and EFTR, with a high success andlow complication rate.

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