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CC BY-NC-ND 4.0 · Endosc Int Open 2026; 14: a28034972
DOI: 10.1055/a-2803-4972
Original article

Preset pursestring procedure: Innovative auxiliary method of endoscopic full-thickness resection in small gastric stromal tumors

Autor*innen

  • Jinfeng Zhou

    1   Department of Gastroenterology, The Third People's Hospital of Shenzhen, Shenzhen, China (Ringgold ID: RIN535206)

  • Min Zhao

    1   Department of Gastroenterology, The Third People's Hospital of Shenzhen, Shenzhen, China (Ringgold ID: RIN535206)

  • Ying Liu

    1   Department of Gastroenterology, The Third People's Hospital of Shenzhen, Shenzhen, China (Ringgold ID: RIN535206)

  • Xiaoyin Zhang

    1   Department of Gastroenterology, The Third People's Hospital of Shenzhen, Shenzhen, China (Ringgold ID: RIN535206)
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Abstract

Background and study aims

Endoscopic full-thickness resection (EFR) of gastric stromal tumors carries a high peritonitis risk. Our case report implied the preset pursestring procedure (PPP) could boost EFR speed and safety, but supporting clinical evidence is lacking, prompting this clinical evaluation of PPP in gastric EFR.

Patients and methods

This retrospective cohort study analyzed adults with small gastric stromal tumors who underwent EFR (n = 31) or PPP-assisted EFR (PPP-EFR, n = 28) between August 2022 and August 2023. Tumor characteristics, adverse events, postoperative efficacy, economic outcomes, and follow-up data were compared between groups.

Results

R0 resection rates were comparable (PPP-EFR: 92.8%; EFR: 90.0%). PPP-EFR had shorter closure time (3.5 vs. 19.5 min, P = 0.001). PPP-EFR had lower incidence of postoperative fever (10.7% vs. 32.3%, P = 0.040), computed tomography-confirmed peritonitis (7.1% vs. 29.0%,P = 0.031), and elevated inflammatory markers (P ≤ 0.003), plus shorter fasting time (P = 0.038). Operative time, hospital stay, and cost did not differ; no patients had recurrence or metastasis on follow-up.

Conclusions

PPP optimizes EFR closure, reduces inflammatory and abdominal complications, and improves postoperative recovery for small gastric stromal tumors.

Keywords

Endoscopy Upper GI Tract - Endoscopic resection (ESD, EMRc, ...) - Quality and logistical aspects - Performance and complications - GI surgery


Publikationsverlauf

Eingereicht: 05. Dezember 2025

Angenommen nach Revision: 02. Februar 2026

Accepted Manuscript online:
03. Februar 2026

Artikel online veröffentlicht:
23. Februar 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Jinfeng Zhou, Min Zhao, Ying Liu, Xiaoyin Zhang. Preset pursestring procedure: Innovative auxiliary method of endoscopic full-thickness resection in small gastric stromal tumors. Endosc Int Open 2026; 14: a28034972.
DOI: 10.1055/a-2803-4972
 

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