Document Detail

Multiband mucosectomy for endoscopic resection of Barrett's esophagus: feasibility study with matched historical controls.
MedLine Citation:
PMID:  17353695     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Piece-meal endoscopic resection of early neoplastic lesions larger than 15-20 mm is a laborious procedure with the cap technique. Multiband mucosectomy is a new technique using a modified variceal band ligator. Submucosal lifting and prelooping of the snare in the cap is not necessary and multiple resections can be performed with a single snare. We prospectively evaluated the feasibility of multiband mucosectomy for widespread endoscopic resection in patients with a Barrett's esophagus with early neoplasia and compared results retrospectively with prospectively registered endoscopic cap resection procedures. RESULTS: Eighty multiband mucosectomy procedures were performed in 40 patients and 86 endoscopic cap resection procedures in 53 patients. Median duration of the multiband mucosectomy procedures was 37 vs. 50 min for endoscopic cap resection procedures (P=0.06); median duration per resection was 6 vs. 12 min, respectively (P<0.001). Mean diameter of the specimens was 17 vs. 21 mm (P<0.001). One perforation in the endoscopic cap resection group was successfully treated conservatively. Mild bleeding occurred in 6% of multiband mucosectomy and 20% of endoscopic cap resection procedures (P=0.012). Technical difficulties during multiband mucosectomy procedures included a decreased visibility owing to the black bands and the releasing wires. CONCLUSIONS: Multiband mucosectomy allows safe and easy widespread piece-meal resections in Barrett's esophagus. Time and costs appear to be saved compared with the cap technique, and multiband mucosectomy appears to cause less bleeding during the endoscopic resection procedure. Multiband mucosectomy, however, results in smaller specimens and is, therefore, most suited for en-bloc resection of lesions smaller than 10 mm or for widespread resection of flat mucosa.
Femke P Peters; Mohammed A Kara; Wouter L Curvers; Wilda D Rosmolen; Paul Fockens; Kausilia K Krishnadath; Fiebo J W Ten Kate; Jacques J G H M Bergman
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  19     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-13     Completed Date:  2007-07-10     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  311-5     Citation Subset:  IM    
Department of Gastroenterology, Academic Medical Center, Amsterdam, Netherlands.
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MeSH Terms
Adenocarcinoma / surgery
Barrett Esophagus / surgery*
Case-Control Studies
Esophageal Neoplasms / surgery
Esophagoscopy / methods*
Feasibility Studies
Mucous Membrane / surgery*
Prospective Studies
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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