Purpose Recently, non-exposure simple suturing endoscopic full-thickness resection (NESS-EFTR) was developed to prevent tumor exposure to the peritoneal cavity. This study aimed to evaluate the feasibility of NESS-EFTR with sentinel basin dissection for early gastric cancer (EGC). Materials and Methods This was the prospective SENORITA 3 pilot. From July 2017 to January 2018, 20 patients with EGC smaller than 3 cm without an absolute indication for endoscopic submucosal dissection were enrolled. The sentinel basin was detected using Tc99m-phytate and indocyanine green, and the NESS-EFTR procedure was performed when all sentinel basin nodes were tumor-free on frozen pathologic examination. We evaluated the complete resection and intraoperative perforation rates as well as the incidence of postoperative complications. Results Among the 20 enrolled patients, one dropped out due to large tumor size, while another underwent conventional laparoscopic gastrectomy due to metastatic sentinel lymph nodes. All NESS-EFTR procedures were performed in 17 of the 18 other patients (94.4%) without conversion, and the complete resection rate was 83.3% (15/18). The intraoperative perforation rate was 27.8% (5/18), and endoscopic clipping or laparoscopic suturing or stapling was performed at the perforation site. There was one case of postoperative complications treated with endoscopic clipping; the others were discharged without any event. Conclusions NESS-EFTR with sentinel basin dissection is a technically challenging procedure that obtains safe margins, prevents intraoperative perforation, and may be a treatment option for EGC after additional experience. Trial Registration ClinicalTrials.gov Identifier: NCT03216174

中文翻译：

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早期胃癌患者的非暴露简单缝合内窥镜全层切除和前哨盆解剖：SENORITA 3 试点研究

目的 最近，为了防止肿瘤暴露于腹膜腔，开发了非暴露简单缝合内镜全层切除术（NESS-EFTR）。本研究旨在评估 NESS-EFTR 与前哨盆解剖治疗早期胃癌 (EGC) 的可行性。材料和方法 这是前瞻性的 SENORITA 3 试点项目。2017 年 7 月至 2018 年 1 月，入组 20 例 EGC 小于 3 cm 且无内镜黏膜下剥离绝对指征的患者。使用Tc99m-植酸盐和吲哚菁绿检测哨兵盆地，当所有哨兵盆地结节在冷冻病理检查中均无肿瘤时进行NESS-EFTR程序。我们评估了完全切除和术中穿孔率以及术后并发症的发生率。结果 20 例入组患者中，1 例因肿瘤体积大而退出，1 例因前哨淋巴结转移行常规腹腔镜胃切除术。其他 18 名患者中有 17 名 (94.4%) 进行了所有 NESS-EFTR 手术，没有中转，完全切除率为 83.3% (15/18)。术中穿孔率为27.8%（5/18），穿孔部位行内镜夹闭或腹腔镜缝合或吻合。内镜夹闭治疗术后并发症1例；其他人无任何情况出院。结论 NESS-EFTR 与前哨盆分离术是一项技术上具有挑战性的手术，它获得了安全的边缘，防止了术中穿孔，并且在获得额外经验后可能是 EGC 的一种治疗选择。