S2213 Efficacy and Safety of Endoscopic Suturing by Early-Career Gastroenterologists: A Retrospective Analysis

Introduction: Endoscopic suturing is an evolving treatment modality for gastrointestinal (GI) defect closure and stent fixation. While established among experienced endoscopists, limited data exist regarding its use by early-career gastroenterologists. We aimed to evaluate the technical and clinical outcomes, safety, and procedural characteristics of endoscopic suturing performed by early-career gastroenterologists. Methods: We conducted a retrospective study of patients undergoing endoscopic suturing by 3 early-career Gastroenterology physicians (≤1.5 years post-fellowship). Data collected included demographics, indication, anatomical site, procedural duration, device used (OverStitch or X-tack), complications, and outcomes. Technical success was evaluated by the proper placement of sutures, while clinical success was studied by the resolution of the specific clinical issue without requiring reintervention in 4 weeks. Procedure time was defined as the duration from the start to the end of anesthesia. Results: Thirty patients (mean age 64.4 ± 13.5 years; 46.7% man) were included. Common indications included fistula closure (36.7%), stent fixation (23.3%), post-polypectomy defect closure (13.3%), perforation management (13.3%), and bleeding control (13.3%). Overall technical success was 96.7% (29/30), and clinical success was 80.0% (24/30). No immediate complications occurred. By anatomical site, clinical success was highest in the colon (100%) and stomach (87.5%), and lowest in the esophagus (62.5%) and small bowel (0%). Clinical success by device was 75.0% for OverStitch and 83.3% for X-tack. Procedural duration averaged 75.2 ± 41.6 minutes. Multivariable regression did not reveal significant predictors of clinical success or shorter procedure time. Conclusion: Endoscopic suturing offers a minimally invasive alternative for patients who would have previously required surgical intervention, thereby reducing the associated morbidity. Adaptation of endoscopic suturing performed by early-career gastroenterologists is safe and effective. These findings support the early training and adoption of suturing techniques for gastroenterology practices.