A Novel Multiband Mucosectomy Device Facilitates Circumferential Endoscopic Mucosal Resection in Barrett's Esophagus with Early Malignant Changes

Seewald, Stefan; Groth, Stefan; Seitz, Uwe; Weerth, Andreas de; Zhong, Yan; Thonke, Frank; Schroeder, Soeren; Soehendra, Nib

doi:10.1016/s0016-5107(05)00601-2

Cited by 4 publications

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“…As a result, more MBM resections may be necessary for removal of the same surface area of Barrett's muco− sa than with the standard cap method. At the annual meeting of the American Society of Gastrointestinal Endoscopy in Chicago in May 2005, Seewald et al [42] reported on 10 patients with HGIN or early cancer who were treated with MBM. Complete resection was carried out in one session using a median of six bands in five of the 10 patients with circumferential Barrett's esophagus with a median length of 4 cm.…”

Section: Future Prospectsmentioning

confidence: 99%

Latest Developments in the Endoscopic Management of Gastroesophageal Reflux Disease and Barrett’s Esophagus: an Overview of the Year’s Literature

Bergman

2006

Endoscopy

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The development of endoscopic techniques for the treatment of gastroesophageal reflux disease has come to an abrupt halt after some of the most widely disseminated and best evaluated techniques were withdrawn from the market. This underlines the importance of conducting high-quality endoscopic research before techniques are adopted in routine practice. The endoscopic surveillance of patients with Barrett's esophagus needs to be improved in order to be cost-effective. Alternative techniques for tissue sampling are being explored (e. g., brush cytology, imaging cytometry), as well as the use of molecular markers, to select patients who are at risk and to improve compliance by patients. New endoscopic imaging techniques (such as autofluorescence endoscopy) may improve the detection of early neoplasia in those Barrett's patients who are at risk for malignant degeneration. Subsequent endoscopic treatment should primarily consist of an endoscopic resection technique with restricted use of ablative therapies. Future studies should focus on the development of endoscopic resection techniques that allow en-bloc resection of Barrett's lesions, stepwise complete resection of the whole Barrett's segment, and/or easier and safer tissue ablation. Finally, histopathological studies are needed in order to detect risk factors for an adverse outcome after endoscopic treatment for early neoplasia in Barrett's patients.

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Section: Future Prospectsmentioning

confidence: 99%

Latest Developments in the Endoscopic Management of Gastroesophageal Reflux Disease and Barrett’s Esophagus: an Overview of the Year’s Literature

Bergman

2006

Endoscopy

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“…Six cases of minor bleeding and one perforation occurred, but 19 patients developed strictures requiring bougienage dur− ing the follow−up. There was a stricture−related surgery rate, ei− ther due to bougienage complications (n = 2) or inability to com− plete EMR due to early stricturing (n = 2); two further patients had to undergo surgery due to submucosal tumor infiltration [44]. Using the same device, the Amsterdam group treated 30 pa− tients with a median Barrett's esophagus length of 5 cm, and a mean of six pieces were harvested; the follow−up results are ap− parently not yet available.…”

Section: Emr Esd and Morementioning

confidence: 99%

UEGW Congress Report, Copenhagen 2005: Review of Endoscopic Abstracts

Rösch¹

2006

Endoscopy

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Assessing the quality of the endoscopic abstracts accepted at the United European Gastroenterology Week (UEGW) meeting is al− ways necessarily subjective and may reflect the progress of en− doscopic research as well as peculiarities of the selection com− mittees. Nevertheless, the author's subjective impression for 2005 was that less original work primarily sent to UEGW was available. In fact, many large studies recently presented were not seen at UEGW ± e. g. papers on double−balloon endoscopy and reports on some new colonoscopes. Instead, a few new tech− niques were sometimes reported without clear−cut results, al− though the authors told us how happy they were. Let's hope this will change in the years to come. Reflux and Barrett's Complex; Early Cancers and ImagingSurveillance of Barrett's esophagus by conventional means, with close observation using modern video endoscopes and four− quadrant biopsies [1, 2], is obviously still thought to be so un− bearable and imperfect that many efforts are being undertaken to improve the situation and avoid the biopsies ± although the percentage of the daily workload taken up by Barrett's esopha− gus surveillance in an average endoscopy center is probably neg− ligible. Staining with various solutions [2, 3] has been suggested as one way of improving lesion detection (although the results have been quite variable [4], and narrow−band imaging (NBI) was developed to more or less replace staining [5, 6]. The Amster− dam group presented the results of a randomized cross−over study in 28 patients with Barrett's esophagus who were exam− ined with high−resolution endoscopy with either staining or NBI within 6 weeks, with no appreciable differences between the two groups [7]. NBI was also tested in the colon on various polyps, and different vascular patterns were described, although clear accuracy rates or correlation values with histology were not given [8].There are currently two ways of imaging early neoplastic lesions: lesion identification and tissue characterization (enthusiastically termed "endoscopic histology"). For identifying lesions, auto− fluorescence [9] is now available in a video format, and ± so far as I understand the abstract ± a group in Japan showed that auto− fluorescence identified five secondary lesions in patients sent for mucosectomy of early gastric cancer, whereas conventional en− doscopy found one [10]. Barrett's esophagus is another area for autofluorescence imaging [11]. In the colon, autofluorescence was used with and without NBI in a variety of lesions, but con− clusions regarding the rate of adenoma detection with autofluor− escence could not be made due to small numbers. NBI prediction of adenomas according to the Kudo classification achieved a sen− sitivity and specificity of 85 % and 90 %, respectively [12].The other area for imaging, tissue characterization, is represen− ted by various techniques such as confocal laser microscopic en− doscopy (CLME) [13 ± 15] and endocytoscopy [16,17]. The latter was investigated in fresh human specimens to test...

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Endoscopic resection for treatment of mucosal Barrett's cancer: time to swing the pendulum

Bergman¹

2007

Gastrointestinal Endoscopy

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A Novel Multiband Mucosectomy Device Facilitates Circumferential Endoscopic Mucosal Resection in Barrett's Esophagus with Early Malignant Changes

Cited by 4 publications

References 0 publications

Latest Developments in the Endoscopic Management of Gastroesophageal Reflux Disease and Barrett’s Esophagus: an Overview of the Year’s Literature

Latest Developments in the Endoscopic Management of Gastroesophageal Reflux Disease and Barrett’s Esophagus: an Overview of the Year’s Literature

UEGW Congress Report, Copenhagen 2005: Review of Endoscopic Abstracts

Endoscopic resection for treatment of mucosal Barrett's cancer: time to swing the pendulum

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