Through-the-scope suture closure of nonampullary duodenal endoscopic mucosal resection defects: A retrospective multicenter cohort study

Jose Antonio Almario; Linda Y. Zhang; Jonathan Cohen; Gregory B. Haber; Hemchand Ramberan; Andrew C. Storm; Stuart Gordon; Jeffrey M. Adler; Heiko Pohl; Alexander Schlachterman; Anand Kumar; Shailendra Singh; Bashar Qumseya; Peter V. Draganov; Nikhil A. Kumta; Andrew Canakis; Raymond Kim; Hiroyuki Aihara; Apurva Shrigiriwar; Saowanee Ngamruengphong; Mouen A. Khashab

doi:10.1055/a-2077-4832

Through-the-scope suture closure of nonampullary duodenal endoscopic mucosal resection defects: A retrospective multicenter cohort study

Jose Antonio Almario, Linda Y. Zhang, Jonathan Cohen, Gregory B. Haber, Hemchand Ramberan, Andrew C. Storm, Stuart Gordon, Jeffrey M. Adler, Heiko Pohl, Alexander Schlachterman, Anand Kumar, Shailendra Singh, Bashar Qumseya, Peter V. Draganov, Nikhil A. Kumta, Andrew Canakis, Raymond Kim, Hiroyuki Aihara, Apurva Shrigiriwar, Saowanee NgamruengphongMouen A. Khashab

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background Delayed bleeding is among the most common adverse events associated with endoscopic mucosal resection (EMR) of nonampullary duodenal polyps.We evaluated the rate of delayed bleeding and complete defect closure using a novel through-the-scope (TTS) suturing system for the closure of duodenal EMR defects. Methods We reviewed the electronic medical records of patients who underwent EMR for nonampullary duodenal polyps of ≥ 10mm and prophylactic defect closure with TTS suturing between March 2021 and May 2022 at centers in the USA. We evaluated the rates of delayed bleeding and complete defect closure Results 36 nonconsecutive patients (61% women; mean [SD] age, 65 [12] years) underwent EMR of ≥ 10-mm duodenal polyps followed by attempted defect closure with TTS suturing. The mean (SD) lesion size was 29 (19) mm, defect size was 37 (25) mm; eight polyps (22%) involved > 50% of the lumen circumference. Complete closure was achieved in all cases (78% with TTS suturing alone), using a median of one TTS suturing kit. There were no cases of delayed bleeding and no adverse events attributed to application of the TTS suturing device.

Original language	English (US)
Pages (from-to)	865-870
Number of pages	6
Journal	Endoscopy
Volume	55
Issue number	9
DOIs	https://doi.org/10.1055/a-2077-4832
State	Published - Sep 1 2023

ASJC Scopus subject areas

Gastroenterology

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Almario, J. A., Zhang, L. Y., Cohen, J., Haber, G. B., Ramberan, H., Storm, A. C., Gordon, S., Adler, J. M., Pohl, H., Schlachterman, A., Kumar, A., Singh, S., Qumseya, B., Draganov, P. V., Kumta, N. A., Canakis, A., Kim, R., Aihara, H., Shrigiriwar, A., ... Khashab, M. A. (2023). Through-the-scope suture closure of nonampullary duodenal endoscopic mucosal resection defects: A retrospective multicenter cohort study. Endoscopy, 55(9), 865-870. https://doi.org/10.1055/a-2077-4832

Almario, JA, Zhang, LY, Cohen, J, Haber, GB, Ramberan, H, Storm, AC, Gordon, S, Adler, JM, Pohl, H, Schlachterman, A, Kumar, A, Singh, S, Qumseya, B, Draganov, PV, Kumta, NA, Canakis, A, Kim, R, Aihara, H, Shrigiriwar, A, Ngamruengphong, S & Khashab, MA 2023, 'Through-the-scope suture closure of nonampullary duodenal endoscopic mucosal resection defects: A retrospective multicenter cohort study', Endoscopy, vol. 55, no. 9, pp. 865-870. https://doi.org/10.1055/a-2077-4832

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abstract = "Background Delayed bleeding is among the most common adverse events associated with endoscopic mucosal resection (EMR) of nonampullary duodenal polyps.We evaluated the rate of delayed bleeding and complete defect closure using a novel through-the-scope (TTS) suturing system for the closure of duodenal EMR defects. Methods We reviewed the electronic medical records of patients who underwent EMR for nonampullary duodenal polyps of ≥ 10mm and prophylactic defect closure with TTS suturing between March 2021 and May 2022 at centers in the USA. We evaluated the rates of delayed bleeding and complete defect closure Results 36 nonconsecutive patients (61% women; mean [SD] age, 65 [12] years) underwent EMR of ≥ 10-mm duodenal polyps followed by attempted defect closure with TTS suturing. The mean (SD) lesion size was 29 (19) mm, defect size was 37 (25) mm; eight polyps (22%) involved > 50% of the lumen circumference. Complete closure was achieved in all cases (78% with TTS suturing alone), using a median of one TTS suturing kit. There were no cases of delayed bleeding and no adverse events attributed to application of the TTS suturing device.",

author = "Almario, {Jose Antonio} and Zhang, {Linda Y.} and Jonathan Cohen and Haber, {Gregory B.} and Hemchand Ramberan and Storm, {Andrew C.} and Stuart Gordon and Adler, {Jeffrey M.} and Heiko Pohl and Alexander Schlachterman and Anand Kumar and Shailendra Singh and Bashar Qumseya and Draganov, {Peter V.} and Kumta, {Nikhil A.} and Andrew Canakis and Raymond Kim and Hiroyuki Aihara and Apurva Shrigiriwar and Saowanee Ngamruengphong and Khashab, {Mouen A.}",

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doi = "10.1055/a-2077-4832",

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T1 - Through-the-scope suture closure of nonampullary duodenal endoscopic mucosal resection defects

T2 - A retrospective multicenter cohort study

AU - Almario, Jose Antonio

AU - Zhang, Linda Y.

AU - Cohen, Jonathan

AU - Haber, Gregory B.

AU - Ramberan, Hemchand

AU - Storm, Andrew C.

AU - Gordon, Stuart

AU - Adler, Jeffrey M.

AU - Pohl, Heiko

AU - Schlachterman, Alexander

AU - Kumar, Anand

AU - Singh, Shailendra

AU - Qumseya, Bashar

AU - Draganov, Peter V.

AU - Kumta, Nikhil A.

AU - Canakis, Andrew

AU - Kim, Raymond

AU - Aihara, Hiroyuki

AU - Shrigiriwar, Apurva

AU - Ngamruengphong, Saowanee

AU - Khashab, Mouen A.

PY - 2023/9/1

Y1 - 2023/9/1

N2 - Background Delayed bleeding is among the most common adverse events associated with endoscopic mucosal resection (EMR) of nonampullary duodenal polyps.We evaluated the rate of delayed bleeding and complete defect closure using a novel through-the-scope (TTS) suturing system for the closure of duodenal EMR defects. Methods We reviewed the electronic medical records of patients who underwent EMR for nonampullary duodenal polyps of ≥ 10mm and prophylactic defect closure with TTS suturing between March 2021 and May 2022 at centers in the USA. We evaluated the rates of delayed bleeding and complete defect closure Results 36 nonconsecutive patients (61% women; mean [SD] age, 65 [12] years) underwent EMR of ≥ 10-mm duodenal polyps followed by attempted defect closure with TTS suturing. The mean (SD) lesion size was 29 (19) mm, defect size was 37 (25) mm; eight polyps (22%) involved > 50% of the lumen circumference. Complete closure was achieved in all cases (78% with TTS suturing alone), using a median of one TTS suturing kit. There were no cases of delayed bleeding and no adverse events attributed to application of the TTS suturing device.

AB - Background Delayed bleeding is among the most common adverse events associated with endoscopic mucosal resection (EMR) of nonampullary duodenal polyps.We evaluated the rate of delayed bleeding and complete defect closure using a novel through-the-scope (TTS) suturing system for the closure of duodenal EMR defects. Methods We reviewed the electronic medical records of patients who underwent EMR for nonampullary duodenal polyps of ≥ 10mm and prophylactic defect closure with TTS suturing between March 2021 and May 2022 at centers in the USA. We evaluated the rates of delayed bleeding and complete defect closure Results 36 nonconsecutive patients (61% women; mean [SD] age, 65 [12] years) underwent EMR of ≥ 10-mm duodenal polyps followed by attempted defect closure with TTS suturing. The mean (SD) lesion size was 29 (19) mm, defect size was 37 (25) mm; eight polyps (22%) involved > 50% of the lumen circumference. Complete closure was achieved in all cases (78% with TTS suturing alone), using a median of one TTS suturing kit. There were no cases of delayed bleeding and no adverse events attributed to application of the TTS suturing device.

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JO - Endoscopy

JF - Endoscopy

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ER -

Through-the-scope suture closure of nonampullary duodenal endoscopic mucosal resection defects: A retrospective multicenter cohort study

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