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Background <p>Endoscopic 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.</p> Methods <p>This 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.</p> Results <p>A total of 84 patients (closure: <i>n</i> = 52; non-closure: <i>n</i> = 32) were included in the analysis. The two groups were well-balanced regarding baseline patient and lesion characteristics, with most tumors being small (≤ 10&#xa0;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%; <i>P</i> = 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&#xa0;days; <i>P</i> = 0.07) or total hospitalization costs (9745.08 ± 3123.66 vs. 9180.34 ± 2647.80 yuan; <i>P</i> = 0.397).</p> Conclusions <p>For small esophageal SMTs (≤ 10&#xa0;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.</p>

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Closure strategies post-EMR for esophageal SMTs

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月9日

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  • Lingling Chen,
  • Genhua Yang,
  • Wei Gong,
  • Chongju Bao

摘要

Background

Endoscopic 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.

Methods

This 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.

Results

A 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).

Conclusions

For 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.