Defect closure with endoscopic suturing improves endoscopic full-thickness resection of duodenal gastrointestinal stromal tumors.

Endoscopic resection of duodenal gastrointestinal stromal tumors (GISTs) is challenging with non-negligible complications [1]. Endoscopic full-thickness resection (EFTR) is usually required [2] but remains uncommon for unsatisfactory defect closure. Clip-based methods are challenging for closing large defects and can be improved with mucosal flap preservation, which is time-consuming [3]. The strong and reliable whole-layer approximation with endoscopic suturing can change the decision-making of EFTR [2] [4] [5].