ArticleSurgical endoscopy2026
Closure strategies post-EMR for esophageal SMTs.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundEndoscopic mucosal resection (EMR) has become a widely adopted minimally invasive treatment for esophageal submucosal tumors (SMTs). Although prophylactic clip closure of the post-EMR wound is commonly performed to reduce complications, its clinical necessity and efficacy lack robust evidence. This study therefore aimed to compare the clinical outcomes of clip closure versus non-closure following EMR for esophageal SMTs.
methodsThis retrospective, single-center cohort study reviewed consecutive patients who underwent EMR for esophageal SMTs between January 2022 and November 2025. Based on post-EMR wound management, patients were allocated to a closure group (prophylactic metallic clip closure) and a non-closure group (observation only). Patient demographics, lesion characteristics, pathological diagnoses, and clinical outcomes including postoperative complications (bleeding, perforation), hospital stay, and costs were collected and analyzed.
resultsA total of 84 patients (closure: n = 52; non-closure: n = 32) were included in the analysis. The two groups were well-balanced regarding baseline patient and lesion characteristics, with most tumors being small (≤ 10 mm), superficial (originating from the muscularis mucosae), and histologically confirmed as leiomyomas. The complication rate was minimal, with only one minor, conservatively managed bleeding event recorded in the closure group (1.9% vs. 0%; P = 1.0) and no perforations in either cohort. Similarly, no significant intergroup differences were observed for postoperative hospital stay (3.98 ± 1.18 vs. 4.47 ± 1.19 days; P = 0.07) or total hospitalization costs (9745.08 ± 3123.66 vs. 9180.34 ± 2647.80 yuan; P = 0.397).
conclusionsFor small esophageal SMTs (≤ 10 mm), prophylactic clip closure after EMR does not confer significant advantages over non-closure in reducing complications, hospital stay, or costs. Therefore, its routine use is not warranted.
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