Clinical Values of Dental Floss Traction Assistance in Endoscopic Full-Thickness Resection for Submucosal Tumors Originating from the Muscularis Propria Layer in the Gastric Fundus.
BACKGROUND
Endoscopic full-thickness resection (EFTR) derived from endoscopic submucosal dissection has gradually been accepted and even promoted for the treatment of submucosal tumors (SMTs) originating from the muscularis propria (MP) layer. However, there are some difficulties when EFTR is used to treat MP lesions in the gastric fundus. This study intends to explore whether EFTR can be made simpler, safer, and more effective with the traction assistance of dental floss.


METHODS
The clinical data of patients (trial group) with lesions in the MP layer in the gastric fundus undergoing EFTR with traction assistance of dental floss at Zhongshan Hospital, in 2016, were reviewed retrospectively. The control group was matched with the trial group according to tumor size. 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, each of which comprised 24 cases (58.7 ± 11.8 years versus 56.6 ± 7.9 years, t = 0.663, P = .511). However, there was a statistically significant difference in the operative time between the two groups (10.8 ± 2.8 minutes versus 19.0 ± 4.7 minutes, t = 7.298, P < .05). There was no statistically significant difference in the length of the postoperative hospital stay (3.2 ± 0.5 days versus 3.2 ± 0.5 days, t = 0.291, P = .772). In the trial group, there were 19 cases of gastrointestinal stromal tumors (group 1) and 5 cases of leiomyoma. The control group had similar results. Neither group experienced postoperative delayed bleeding, perforation, or other complications.


CONCLUSIONS
When EFTR is used to treat SMTs originating from the MP in the gastric fundus, dental floss traction assistance can relieve the tumor boundary to simplify the surgical procedure and save the operation time.
['Shi|Qiang|Q|', 'Li|Bing|B|', 'Qi|Zhi-Peng|ZP|', 'Yao|Li-Qing|LQ|', 'Xu|Mei-Dong|MD|', 'Cai|Shi-Lun|SL|', 'Sun|Di|D|', 'Zhou|Ping-Hong|PH|', 'Zhong|Yun-Shi|YS|']
D000328:Adult D000368:Aged D003742:Dental Devices, Home Care D000069916:Endoscopic Mucosal Resection D005260:Female D005500:Follow-Up Studies D005748:Gastric Fundus D005753:Gastric Mucosa D005773:Gastroscopy D006801:Humans D007902:Length of Stay D008297:Male D008875:Middle Aged D061646:Operative Time D011183:Postoperative Complications D012189:Retrospective Studies D013274:Stomach Neoplasms D014143:Traction D016896:Treatment Outcome
dental floss traction assistance endoscopic full-thickness resection submucosal tumor