The over-the-scope clip (OTSC) system was developed not only for the closure of gastrointestinal defects but can also be used to assist endoscopic resection. The aim of this study was to compare and analyse the feasibility and safety of two methods of EFTR for the management of challenging epithelial and subepithelial neoplasms that are not amenable to conventional resection techniques.Methods
This was a retrospective case series study of patients underwent two methods of endoscopic full-thickness resection (EFTR), either of which was deep resection using ESD knives and post-resection closure with OTSC (Group 1), the other was pre-resection closure with OTSC and second EFTR with snare (Group 2).Results
Of all 21 patients, 11 cases were in Group 1 and 10 in Group 2. The mean time of EFTR procedure was 76.83±34.97 min in Group 1 which was significantly longer than that of Group 2 (p=0.0128). The mean time of OTSC closure and length of hospital stay of Group 1 were also longer compared to Group 2, but the difference was not significant. Both of complete resection (R0) and technical success rate of Group 1 were 83.3% and were both 100% for Group 2.Conclusions
EFTR for pre-resection closure is potentially faster compared with the concept of applying closure after EFTR. Larger prospective controlled studies comparing those two techniques are warranted in the future.