{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T18:29:41Z","timestamp":1774463381768,"version":"3.50.1"},"reference-count":29,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestion"],"abstract":"<jats:p>Introduction: Reliable closure of mucosal\/full-thickness defects after endoscopic treatment is crucial to prevent complications. Although various techniques have been clinically introduced, a direct comparison of these techniques has not been conducted. Thus, the present ex vivo study aimed to evaluate the closure strength of these methods. Methods: Using a porcine stomach, 4 \u00d7 2.5-cm mucosal and full-thickness defects were prepared. Each closure was performed for three specimens. For the mucosal defects, the following methods were performed in the mucosal (group M) and muscular-mediated mucosal (group MM) closures: simple clipping (clip-M), loop-assisted closure (loop-M), line-assisted closure (line-M), and endoscopic hand suturing (EHS-M); clip-MM, line-MM, and EHS-MM. For the full-thickness defects, a single-layered closure (group F) was performed by loop-assisted closure (loop-F), line-assisted clip closure (line-F), and EHS (EHS-F). The maximum tension (N) was measured using a mechanical traction device by mechanically pulling both ends of the specimen. Results: In the closure of mucosal defects, among the techniques in group M, EHS-M (11.32 \u00b1 2.1 N) demonstrated the highest strength as compared to the other three methods. For group MM, EHS-MM (13.1 \u00b1 5.3 N) showed the highest strength, significantly outperforming clip-MM (p = 0.03). Among the full-thickness defect closure methods, EHS-F (9.5 \u00b1 0.73 N) had the significantly highest strength among the three methods. Conclusions: Our ex vivo data showed that EHS has superior closure strength in both mucosal and full-thickness defects. Surgery-oriented endoscopic closure appears to be a reliable method for artificially created intraluminal defects.<\/jats:p>","DOI":"10.1159\/000550836","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T17:01:02Z","timestamp":1770915662000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Evaluation of Endoscopic Closure Techniques for Mucosal and Full-Thickness Defects: An ex vivo Study"],"prefix":"10.1159","author":[{"given":"Shun","family":"Nakagome","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Goto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriko","family":"Nishiyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8080-8151","authenticated-orcid":false,"given":"Tsugumi","family":"Habu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eriko","family":"Koizumi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4386-6288","authenticated-orcid":false,"given":"Kazutoshi","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Omori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9880-4143","authenticated-orcid":false,"given":"Naohiko","family":"Akimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8508-827X","authenticated-orcid":false,"given":"Hideki","family":"Kobara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhiko","family":"Iwakiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/pl00011720"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2006.03.932"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1215010"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05776-3"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/den.14911"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.16722"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-007-9696-8"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1111\/den.13010"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.vgie.2019.03.010"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-011-1644-y"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-07311-x"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v12.i1.17"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.07.057"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4076-2"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-020-06508-8"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/den.14466"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111\/den.14562"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1055\/a-1364-4160"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1377180"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.5114\/wiitm.2021.104496"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v13.i7.645"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08443-9"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1055\/a-1884-0065"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1159\/000018773"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.21614\/chirurgia.3138"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-023-01920-z"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2023.01.005"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/den.14748"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i30.5557"}],"container-title":["Digestion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000550836","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T17:00:46Z","timestamp":1774458046000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000550836"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":29,"URL":"https:\/\/doi.org\/10.1159\/000550836","archive":["Portico"],"relation":{},"ISSN":["0012-2823","1421-9867"],"issn-type":[{"value":"0012-2823","type":"print"},{"value":"1421-9867","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]}}}