ArticleiGIE : innovation, investigation and insights2026
Case series of hemostatic outcomes of defect closure using a novel anchor-pronged clip after gastric endoscopic submucosal dissection.
Article in iGIE : innovation, investigation and insights, 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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Abstract
Background and Aims: Delayed bleeding (DB), occurring in 4.1% to 8.5% of gastric endoscopic submucosal dissection (ESD) cases, is one of the most common adverse events. The aim of this study was to evaluate whether defect closure using the novel anchor-pronged clip after gastric ESD contributes to the prevention of DB. Methods: A retrospective study at Chiba University Hospital (Chiba, Japan) included consecutive patients who underwent gastric ESD (August 2023-August 2024). The primary outcome was the rate of DB in the effective closure group, whereas the secondary outcomes included the effective closure rate and the full closure rate. Effective closure (≥50% of defect area) rate was defined as the proportion of study cases among all 127 cases. Full closure (≥90% of defect area) rate was defined as the proportion of study lesions among all 145 lesions during the period. The operators attempted to perform closure with the novel anchor-pronged clip for all cases. Among these, cases with effective closure were mainly analyzed. The first clip placed for defect closure was the novel anchor-pronged clip to achieve mucosa-to-mucosa or mucosa-to-muscle-layer closure. Additional clips could be either the same anchor-pronged clip or other typical through-the-scope clips. Clinical outcomes and adverse events including DB was calculated. Results: Out of 127 cases and 145 lesions, 111 cases and 124 lesions were included in the main analysis. The DB rate was 1.8%. The median diameters (interquartile range) (mm) of the macroscopic lesion and resected specimen were 10 (9-15) and 30 (25-35), respectively. The median closure time per lesion was 9 minutes. The effective closure and the full closure rate was 87.4% and 80.0%, respectively. Conclusions: Defect closure with the novel anchor-pronged clip after gastric ESD was associated with a high effective closure rate and a low DB rate (1.8%), suggesting that this method may help reduce the risk of DB.
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