Gastroenterology · 3 h ago
Hand suturing linked to fewer adverse events after gastric ESD
In a multicenter retrospective propensity score-matched study, 123 patients who underwent endoscopic hand suturing after gastric endoscopic submucosal dissection (ESD) were compared with 369 controls. Post-ESD adverse events and delayed bleeding were less frequent in the suturing group, although the findings are observational.
- Adverse events: 1.6% with suturing versus 8.9% in controls
- Delayed bleeding: 1.6% versus 8.4%
- Complete closure achieved in 94.7% of procedures
- Retrospective design limits causal conclusions
This multicenter retrospective study included patients treated at three institutions between 2020 and 2024. After propensity score matching, outcomes in 123 patients who received endoscopic hand suturing (EHS) of gastric ESD defects were compared with those in 369 controls, including historical and contemporaneous patients. The primary endpoint was the incidence of post-ESD adverse events.
Adverse events occurred in 1.6% of the EHS group and 8.9% of controls (P<0.01). Delayed bleeding occurred in 1.6% and 8.4%, respectively (P<0.01). Complete closure was achieved in 124 of 131 EHS procedures (94.7%); median suturing time was 52.5 minutes. Dehiscence on postoperative day 5 occurred in 27% but was not associated with increased delayed bleeding. Exploratory analyses found larger absolute risk reductions among patients classified as high or very high risk. Closure rates approached 100% after approximately 25 cases.
The results suggest EHS may reduce adverse events after gastric ESD, but the retrospective design and use of historical as well as contemporaneous controls limit causal interpretation. Suturing also required a median of 52.5 minutes, and success improved with operator experience. The findings do not establish that EHS should routinely replace other management approaches.
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Endoscopy: Efficacy of Endoscopic Hand Suturing for Prevention of Adverse Events After Gastric Endoscopic Submucosal Dissection: A Multicenter Propensity Score-Matched Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.