LAUSR

BACKGROUND AND AIMS The current methods for treatment of giant gastric bezoars mainly include chemical dissolution, endoscopic fragmentation, and surgical removal, which often have limited curative effects or generate multiple adverse events. Therefore, there is an urgent need to find new methods to overcome such a dilemma. The aim of this study was to evaluate the safety, efficacy and feasibility of a novel guidewire-based tangential sawing fragmentation (GTSF) technique to treat giant gastric bezoars. METHODS The retrospective single-center study was performed in the Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital. Ten patients with giant bezoars were consecutively enrolled from December 8, 2019 to April 8, 2021. We treated the 10 patients with the GTSF technique, recorded the GTSF procedure, and followed up the patients with gastroscopy in 2 weeks after the procedure. RESULTS All the patients were successfully treated by the GTSF technique and the giant bezoar was broken into small pieces (< 2 cm in diameter). The average operation time was 21.73 minutes, and the average fragmentation time was 8.06 minutes. Ten patients treated with the GTSF technique obtained satisfactory treatment results, no acute adverse events occurred during the procedure, no alimentary canal injury and no bezoar residues left evidenced by gastroscopy after 2 weeks of the procedure. CONCLUSION GTSF technique is a safe, effective, and feasible method for removing giant bezoars, and can be considered as an alternative treatment of this disease.