Two novel devices are similarly effective for tissue approximation of large endoscopic resection defects, but each has advantages, shows new research presented in October at the American College of Gastroenterology (ACG) Annual Scientific Meeting.
"We know from previous data that defect closure is beneficial, and reduces complications such as delayed bleeding and delayed perforation," said Salmaan A. Jawaid, MD, of Baylor College of Medicine, Houston, in a presentation at the meeting.
In the past, defect closure was relatively straightforward; however, "the characteristics of these defects are evolving," and defects are increasing in size, complexity, and number of locations, he said.
In response, management of resection defects has shifted from a one-step closure to a two-step process with approximation of the widest mucosal edges first, followed by complete resection bed closure, Dr. Jawaid said.
Two novel through the scope (TTS) tissue approximation devices used for the closure of large endoscopic resection defects – the dual-action tissue clip (DAT) and the TTS tack/suture device (TSD) – have not been directly compared on the basis of efficacy and cost, he said.
In the current study, Dr. Jawaid and colleagues randomized 56 adults undergoing tissue approximation and defect closure after endoscopic resection to DAT (31 patients) or TSD (25 patients).
