{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T04:10:52Z","timestamp":1749787852414,"version":"3.41.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Effective tissue traction is crucial for gastric endoscopic full-thickness resection (EFTR) to ensure a clear visual field for the dissection site. We aimed to evaluate the effectiveness of internal traction using a novel clip-with-spring device in assisting gastric EFTR.<\/jats:p><jats:p>Twenty-six patients with gastric subepithelial lesions from the muscularis propria were enrolled for internal traction-assisted EFTR (IT-EFTR) and 26 patients for non-assisted EFTR (NA-EFTR) were enrolled as controls.<\/jats:p><jats:p>Average tumor size was 1.5 \u00b1 0.4 cm. All EFTRs were completed successfully with an average total procedure time of 62.4 \u00b1 43.0 minutes and perforation time of 37.2 \u00b1 29.9 minutes. En bloc resection was achieved in 50 patients (96.2%). IT-EFTR significantly improved serosa exposure score (3.4 \u00b1 0.9 vs. 1.9 \u00b1 0.7, P &lt;0.001) and shortened total procedure time (33.0 \u00b1 21.8 vs. 91.8 \u00b1 38.6 min, P &lt;0.001) and perforation time (19.0 \u00b1 18.8 vs. 55.5 \u00b1 27.8 min, P &lt;0.001) compared with NA-EFTR. There were no significant differences in complication rates between the two groups. However, visual analogue score after the procedure was significantly lower (4.2 \u00b1 1.0 vs. 4.7 \u00b1 0.7, P=0.037) and postoperative hospital stay (3.7 \u00b1 2.1 vs. 4.8 \u00b1 1.3, P=0.038) was significantly shorter in the IT-ERTR group than in the NA-EFTR group.<\/jats:p><jats:p>Internal traction using the novel clip-with-spring device could significantly improve safety and efficacy of gastric EFTR in the distal stomach.<\/jats:p>","DOI":"10.1055\/a-2544-2572","type":"journal-article","created":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:31:56Z","timestamp":1740184316000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Internal traction in endoscopic full-thickness resection for gastric subepithelial lesions arising from the muscularis propria: Comparative study"],"prefix":"10.1055","volume":"13","author":[{"given":"Jun","family":"Li","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojia","family":"Hou","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shanghai Tenth People's Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kangsheng","family":"Peng","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Huang","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Liu","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1111\/den.14474","article-title":"Endoscopic full-thickness resection, indication, methods and perspectives","volume":"35","author":"K Wang","year":"2023","journal-title":"Dig Endosc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2880","DOI":"10.1007\/s00464-018-6585-2","article-title":"Usefulness of the thread-traction method in endoscopic full-thickness resection for gastric submucosal tumor: a comparative study","volume":"33","author":"J Li","year":"2019","journal-title":"Surg 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Ni","year":"2023","journal-title":"Oncol Lett"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1089\/lap.2018.0030","article-title":"Clinical values of dental floss traction assistance in endoscopic full-thickness resection for submucosal tumors originating from the muscularis propria layer in the gastric fundus","volume":"28","author":"Q Shi","year":"2018","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3864","DOI":"10.1007\/s00464-019-06920-w","article-title":"The efficacy of dental floss and a hemoclip as a traction method for the endoscopic full-thickness resection of submucosal tumors in the gastric fundus","volume":"33","author":"B Li","year":"2019","journal-title":"Surg Endosc"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.14309\/ctg.0000000000000539","article-title":"Comparison between preincision traction and on-demand traction in assisting colorectal endoscopic submucosal 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videos)","volume":"93","author":"M Nagata","year":"2021","journal-title":"Gastrointest Endosc"}],"container-title":["Endoscopy International 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