Facilitating endoscopic full‐thickness resection for gastric submucosal tumors with a novel snare traction method (with video)

Background and Aim Endoscopic full‐thickness resection (EFTR) is a promising technique in treating gastric submucosal tumors originating from the muscularis propria (SMT‐MPs). However, it is challenging without counter‐traction. Methods A snare was inserted through the forceps channel to grasp the part of the tumor or the mucosa connected to the tumor. The outer sheath and inner wire of snare in vitro were fixed by a pair of hemostatic forceps. The handle of snare was cut off, and the endoscope was pulled out without affecting the traction state of snare. Snare‐assisted EFTR (EFTR‐S) was then performed with counter‐traction. One hundred and four patients with gastric SMT‐MPs who received the procedure of EFTR with or without snare traction method were retrospectively analyzed using univariate and multiple regressions, and covariates were adjusted in the multiple analysis. Results Compared with EFTR group (n = 36), EFTR‐S group (n = 68) showed a higher operative success rate (95.6% vs 72.2%, P = 0.001), a lower incidence of intraoperative hemorrhage (4.4% vs 16.7%, P = 0.038) and shorter operative time among operative successes (53.6 ± 16.6 min vs 67.7 ± 33.4 min, P