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Rev Esp Enferm Dig. 2016 May;108(5):250-6. doi: 10.17235/reed.2016.4031/2015.

Endoscopic band ligation without resection in selected patients for small and superficial upper gastrointestinal tract lesions.

Author information

1
Gastroenterología, Hospital Universitari de Bellvitge-IDIBELL, España.
2
Endoscopia/Aparato Digestivo, Hospital Universitari de Bellvitge, España.
3
Hospital Universitari de Bellvitge-IDIBELL.
4
Institut Català d'Oncologia DiR-IDIBELL.

Abstract

BACKGROUND AND AIM:

The aim of this study was to evaluate the efficacy of endoscopic band ligation (EBL) in carefully selected patients who would benefit from this method of resection.

METHODS:

Patients with early upper gastrointestinal and small (< 15 mm) lesions treated with EBL (Duette® Multi-Band Mucosectomy) were prospectively recruited and retrospectively analyzed between 2010 and 2015. All cases were discussed in a multidisciplinary cancer committee and it was concluded that, owing to patient conditions, surgery was not possible and that not conducting histology would not change the clinical management. A first endoscopic control with biopsies was planned at 4-8 weeks. If there was no persistence of the lesion, new controls were programmed at 6 and 12 months.

RESULTS:

The group (n = 12) included 5 esophagus lesions (adenosquamous carcinoma, n = 1; carcinoma squamous, n = 2; adenocarcinoma, n = 2); 4 gastric lesions (high grade dysplasia, n = 1; adenocarcinoma, n = 2; neuroendocrine tumor [NET], n = 1), and 3 duodenal lesions (NETs) (n = 3). The mean tumor diameter was 9.6 ± 2.8 mm (range 4-15). Only one minor adverse event was described. At first follow-up (4-8 weeks), there was 91.6% and 75% of endoscopic and histological remission, respectively. At 6-month follow-up there was 70% of both endoscopic remission and negative biopsies. And at 12 months, there was 100% and 75% of endoscopic and histological remission, respectively. Persisting lesions were T1 cancers. The median follow-up was 30.6 months.

CONCLUSION:

EBL without resection is an easy and safe technique that should be considered in patients with multiple morbidities and small superficial UGI lesions.

PMID:
27022723
DOI:
10.17235/reed.2016.4031/2015
[Indexed for MEDLINE]
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