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Novel endoscopic tangential sawing technique in treatment of giant gastric bezoars: a retrospective single-center study (with video)

  • Author Footnotes
    ∗ Drs Hu, Guo, and Xu contributed equally to this article.
    Xiao Hu
    Footnotes
    ∗ Drs Hu, Guo, and Xu contributed equally to this article.
    Affiliations
    Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
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  • Author Footnotes
    ∗ Drs Hu, Guo, and Xu contributed equally to this article.
    Qiang Guo
    Footnotes
    ∗ Drs Hu, Guo, and Xu contributed equally to this article.
    Affiliations
    Department of Geriatrics, Chengdu First People’s Hospital, Chengdu, Sichuan Province, China
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  • Author Footnotes
    ∗ Drs Hu, Guo, and Xu contributed equally to this article.
    Qin-wei Xu
    Footnotes
    ∗ Drs Hu, Guo, and Xu contributed equally to this article.
    Affiliations
    Endoscopy Center, Department of Gastroenterology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
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  • Ren-yi Zhang
    Affiliations
    Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
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  • Yun-chao Yang
    Affiliations
    Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
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  • Sheng-xi Han
    Affiliations
    Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
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  • Wei-hui Liu
    Correspondence
    Reprint requests: Wei-hui Liu, MD, PhD, Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China. 32 Second Section of West Ring Road, Qingyang District, Chengdu, Sichuan Province, China, 610072.
    Affiliations
    Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
    Search for articles by this author
  • Author Footnotes
    ∗ Drs Hu, Guo, and Xu contributed equally to this article.
Published:January 08, 2022DOI:https://doi.org/10.1016/j.gie.2021.12.040

      Background and Aims

      The current methods for treatment of giant gastric bezoars mainly include chemical dissolution, endoscopic fragmentation, and surgical removal, which often have limited curative effects or generate multiple adverse events. Therefore, there is an urgent need to find new methods to overcome such a dilemma. The aim of this study was to evaluate the safety, efficacy, and feasibility of a novel guidewire-based tangential sawing fragmentation (GTSF) technique to treat giant gastric bezoars.

      Methods

      This retrospective single-center study was performed in the Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital. Ten patients with giant bezoars were consecutively enrolled from December 8, 2019 to April 8, 2021. We treated the 10 patients with the GTSF technique, recorded the GTSF procedure, and followed the patients with gastroscopy 2 weeks after the procedure.

      Results

      All patients were successfully treated by the GTSF technique, and the giant bezoar was broken into small pieces (<2 cm in diameter). The average operation time was 21.73 minutes, and the average fragmentation time was 8.06 minutes. Ten patients treated with the GTSF technique attained satisfactory treatment results, with no acute adverse events or alimentary canal injury during the procedure, and no bezoar residue remained as shown by gastroscopy 2 weeks after the procedure.

      Conclusions

      The GTSF technique is a safe, effective, and feasible method for removing giant bezoars and can be considered as an alternative treatment of this disease.

      Abbreviation:

      GTSF (guidewire-based tangential sawing fragmentation)
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