EDLS-clips in Endoscopic Full-thickness Resection

December 12, 2025 updated by: Mingliang Feng, First Hospital of China Medical University

Analysis of the Clinical Effect of EDLS-clips in Endoscopic Full-thickness Resection

A retrospective analysis was conducted on patients who visited from March 2022 to May 2024 and underwent endoscopic full-thickness resection and double-layer suture with titanium clips under endoscopy. The basic clinical information, tumor characteristics, overall resection rate and postoperative complications of all patients were evaluated. To analyze the clinical effect of double-layer suture technique with titanium clips under endoscopy in clamping the wound surface after full-thickness endoscopic resection.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

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Detailed Description

The clinical data of patients who underwent endoscopic double-layer suture with titanium clip after endoscopic full-thickness resection at the Endoscopy Center of the First Affiliated Hospital of China Medical University from March 2022 to May 2024 were collected. Indications for endoscopic treatment of SMT: ① For tumors suspected of having malignant potential through preoperative examination or confirmed by biopsy pathology, especially for those suspected of having GIST with a preoperative long diameter of ≤2cm, low risk of recurrence and metastasis, and possibly complete resection, endoscopic resection can be performed. For suspected low-risk GIST with a tumor long diameter greater than 2cm and preoperative assessment excluding lymph node or distant metastasis, under the premise of ensuring complete tumor resection, endoscopic resection can be considered to be carried out by experienced endoscopists in units with mature endoscopic treatment techniques. ② SMT with symptoms (such as bleeding, obstruction). ③ Patients who are suspected of being benign by preoperative examination or confirmed by pathology, but cannot be followed up regularly or whose tumors increase in a short period of time during the follow-up period, or who have a strong willingness for endoscopic treatment. When the tumor protrudes into the serosa or partially grows outside the cavity, or when it is found during the operation that the tumor is closely adhered to the serosa layer and cannot be separated, EFTR can be selected for endoscopic treatment. Complications related to SMT in endoscopic treatment: (1) Intraoperative bleeding: Bleeding that causes the patient's hemoglobin to drop by more than 20g/L. (2) Postoperative bleeding: Postoperative bleeding is manifested as hematemesis, melena or hematochezia, etc. In severe cases, there may be manifestations of hemorrhagic shock. It mostly occurs within one week after the operation, but it can also appear 2 to 4 weeks after the operation. (3) Delayed perforation: It is usually manifested as abdominal distension, aggravated abdominal pain, signs of peritonitis, fever, and imaging examination shows gas accumulation or an increase in gas accumulation compared to before. (4) Gas-related complications: including subcutaneous emphysema, mediastinal emphysema, pneumothorax and pneumoperitoneum, etc. (5) Digestive tract fistula: Digestive juices caused by endoscopic surgery flow into the thoracic or abdominal cavity through the leakage channel. From a patient's medical records collected in the patient's age, gender, lesion characteristics, endoscopic treatment and postoperative clinical course details and other information. The investigators define the position of the lesion on the short axis as the position of the lesion center. The closure time is defined as the period from the start (when the investigators insert the clamp into the visual field channel) to the end of closure (when the last clamp is released).

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
43

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Liaoning
      • Shenyang, Liaoning, China, 110001
        • The First Hospital of China Medical University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

This study comprises case series of 43 patients with gastric SMTs who underwent EDLS-clips after EFTR in our center from March 2022 to May 2024.

Description

Inclusion Criteria:

  1. Having a tumor located in the stomach and confirmed to originate from the muscularis propria on endoscopic ultrasonography (EUS);
  2. Having a tumor diameter >1 cm, which can be completely resected using endoscopic techniques, and with low risk of residue and recurrence;
  3. Preoperative assessment excluded those with lymph node or distant metastasis;
  4. Being able to tolerate tracheal intubation anesthesia, with no coagulation dysfunction or anticoagulant drugs stopped before EFTR.

Exclusion Criteria:

  1. Patients who have been evaluated preoperatively and are considered to have lymph node or distant metastasis;
  2. who cannot tolerate general anesthesia with endotracheal intubation,
  3. who have not discontinued anticoagulant drugs before EFTR or have coagulation dysfunction.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
The complete closure rate of EDLS-clips
Time Frame: Perioperative/Periprocedural
Successful closure refers to the full coverage of the mucosal defect by surrounding normal mucosa without any gaps.
Perioperative/Periprocedural

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Operative time
Time Frame: Perioperative/Periprocedural
Operative time refers to the duration of the entire tumor resection and suture process (from the first incision of the mucosa with the knife to the completion of wound closure).
Perioperative/Periprocedural
Suturing time
Time Frame: Perioperative/Periprocedural
Suturing time was defined as the period from when the operator inserts the first metallic clip through the instrument channel to close the wound until the release of the final metallic clip (for cases involving simultaneous cutting and suturing, the suturing time includes part of the tumor resection time).
Perioperative/Periprocedural

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
First Hospital of China Medical University

Study record dates

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Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 1, 2022

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 31, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 31, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 24, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 12, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 26, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
December 26, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 12, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • End-D-F1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Investigators share the technical operation of this endoscopic double-layer suture method for closing the wounds after endoscopic full-thickness resection (EFTR) for gastric submucosal tumors (SMTs) using endoscopic double-layer suturing method using metal clips (EDLS-clips). This study included 43 patients with gastric SMTs who received EFTR and were treated with EDLS-clips from March 2022 to May 2024 at our center. The primary outcome was the complete closure rate by EDLS-clips. Secondary outcomes included closure time, the number of clips used, and adverse events.

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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