Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett's neoplasia

Pouw, Roos E.; Vilsteren, Frederike G.I. van; Peters, Femke P.; Herrero, Lorenza Alvarez; Kate, Fiebo J.W. ten; Visser, Mike; Schenk, B.E.; Schoon, Erik J.; Peters, Frans; Houben, Martin H.; Bisschops, Raf; Weusten, Bas L.; Bergman, Jacques J.G.H.M.

doi:10.1016/j.gie.2011.03.1243

Cited by 167 publications

(120 citation statements)

References 17 publications

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“…EMR is considered a relatively safe technique, with complications including bleeding (10%) (24,26), perforation (3%) (24,26) and stricture formation. The risk of stricture formation is proportionate to the size and circumference of the lesion, with up to a 37% risk.…”

Section: Section B: Emrmentioning

confidence: 99%

Endoscopic submucosal dissection and endoscopic mucosal resection for early stage esophageal cancer

Niu¹,

Abdelfatah²,

Othman³

2017

Ann. Cardiothorac. Surg.

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Mortality from esophageal cancer remains high despite advances in medical therapy. Although the incidence of squamous cell carcinoma of the esophagus remains unchanged, the incidence of the esophageal adenocarcinoma has increased over time. Gastroesophageal reflux disease (GERD and obesity are contributing factors to the development of Barrett's esophagus and subsequent development of adenocarcinoma. Early recognition of the disease can lead to resection of esophageal cancer prior to the development of lymphovascular invasion. Various modalities have been implemented to aid identification of precancerous lesions and early esophageal cancer. Chromoendoscopy, narrowband imaging and endoscopic ultrasound examination are typically used for evaluating early esophageal lesions. Recently, confocal laser endomicroscopy (CLE) and volumetric laser scanning were implemented with promising results. Endoscopic management of early esophageal cancer may be done using endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Both techniques allow resection of the mucosa (and possibly a portion of the submucosa) containing the early tumor without interruption of deeper layers. A submucosal injection creating a cushion coupled with snare resection or cap assisted mucosal suction followed by ligation and snare resection are the most common techniques of EMR. EMR can remove lesions less than 2 cm in size en bloc. Larger lesions may require resection in piecemeal fashion. This may limit assessment of the margins of the lesion and orienting the lesion's border. ESD offers en bloc dissection of the lesion regardless of its size. ESD is performed with specialized needle knives, which allow incision followed by careful dissection of the lesion within the submucosal layer. Tumor recurrence after ESD is rare but the technique is labor intensive and has an increased risk of perforation. Esophageal stenosis remains a concern after extensive EMR or ESD. Dilation with balloon or stent placement is usually sufficient to treat post-resection stenosis.

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Section: Section B: Emrmentioning

confidence: 99%

Endoscopic submucosal dissection and endoscopic mucosal resection for early stage esophageal cancer

Niu¹,

Abdelfatah²,

Othman³

2017

Ann. Cardiothorac. Surg.

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“…Multi-band mucosectomy (MBM) is a variation of the band ligator technique which uses a specialized banding device that contains multiple bands and allows passage of a snare through the banding cap so that multiple resections can be performed in quick succession. MBM has been shown to be quicker and less expensive than the cap technique, with comparable safety and efficacy (64). An analysis of 1,000 patients with intramucosal EAC treated with EMR reported a complete response in 96.3% of patients after a median follow up period of 5 years (65).…”

Section: Ermentioning

confidence: 99%

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Mansour

El–Serag

Anandasabapathy

2017

Ann. Cardiothorac. Surg.

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Barrett's esophagus (BE) is a premalignant condition that increases the risk of esophageal adenocarcinoma (EAC). Significantly more common in the Western world, risk factors include increased age, male sex, white race, gastro-esophageal reflux disease (GERD), central obesity, and cigarette smoking. The rates of progression to cancer depend on the grade of Barrett's dysplasia. Screening for BE is recommended in patients with GERD and additional risk factors. Endoscopic surveillance of patients with BE likely improves overall outcomes. Advanced endoscopic imaging can help increase the efficiency of current endoscopic surveillance.Endoscopic therapy is safe and effective for the treatment of dysplastic BE and intramucosal EAC, but ongoing surveillance following treatment is necessary. This review will cover screening, surveillance, advanced imaging, chemoprevention, endoscopic treatment, and post-treatment surveillance of BE.

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“…A randomized trial comparing cap-assisted with ligation-assisted EMR for the resection of Barrett's esophagus-associated neoplasia demonstrated that ligation-assisted EMR was significantly faster than cap-assisted EMR with median procedures times of 34 and 50 min, respectively (p = 0.02), with no differences in rates of adverse events or quality of the resection specimens [53].…”

Section: Barrett's Esophagusmentioning

confidence: 99%

Endoscopic Resection Techniques

Hoffman¹,

Heesen²,

Kollmar³

et al. 2017

Visc Med

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Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett's neoplasia

Cited by 167 publications

References 17 publications

Endoscopic submucosal dissection and endoscopic mucosal resection for early stage esophageal cancer

Endoscopic submucosal dissection and endoscopic mucosal resection for early stage esophageal cancer

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Endoscopic Resection Techniques

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