Over-the-scope clip-assisted method for resection of full-thickness submucosal lesions of the gastrointestinal tract.

Background and study aims: The over-the-scope clip (OTSC; Ovesco Endoscopy, Tbing, Germany) is deployed after suctioning tissue into the cap. The tissue may then be resected endoscopically. The aim of this study was to evaluate the efficacy and safety of the OTSC for the endoscopic resection of gastrointestinal tumors. Patients and methods: This was a retrospective, observational cohort study of patients undergoing endoscopic resection of submucosal lesions. Results: Eight patients underwent endoscopic resection of neuroendocrine tumors (NETs) of the duodenum (n=4), rectum (n=1), or stomach (n=2), or granular cell tumor (GCT) of the esophagus (n=1). The mean size of the lesions was 13.4mm (range 9-20mm). Application of the clip was successful in all patients. A successful endoscopic resection was accomplished in all. A complete resection (R0) was accomplished in 7/8 patients (87.5%). A full-thickness resection was achieved in 2/8 (25.0%), one in a patient with a gastric NET and the other in a patient with GCT of the esophagus. There were no complications. Conclusions: This case series suggests that the OTSC system may be a valuable tool for the resection of submucosal lesions, but further prospective and randomized studies are necessary to assess the indications and outcome.