Loop-assisted inversion and double suture technique: a new endotherapy for gastric fundal subepithelial lesions

Abstract

The loop-assisted inversion and double suture technique has been used as an endoscopic treatment for gastric fundal subepithelial lesions. This study aimed to analyse the efficacy and safety of the loop-assisted inversion and double suture technique for the treatment of gastric fundal subepithelial lesions. Consecutive patients with gastric fundal tumours who underwent the loop-assisted inversion and double suture technique at our centre between January 2023 and January 2024 were retrospectively assessed. The primary outcome was surgical success. Twelve patients with 14 gastric fundal subepithelial lesions underwent the loop-assisted inversion and double suture technique during the study period. Two patients had double lesions. Pathology confirmed that out of 14 lesions, 12 were gastrointestinal stromal tumors and 2 were leiomyomas.All the gastrointestinal stromal tumors were of low-risk G1. Operative success was achieved in 14 lesions with complete resection, with no intraoperative transfer to surgery; no adverse effects, including postoperative perforation and bleeding; and no postoperative antibiotic use. During the follow-up period, all 14 lesions showed no recurrence. The loop-assisted inversion and double suture technique is a safe, effective, and time-saving endoscopic treatment for gastric fundal subepithelial lesions. However, prospective large-scale multicentre studies are required.