A randomized trial comparing multiband mucosectomy and cap-assisted endoscopic resection for endoscopic piecemeal resection of early squamous neoplasia of the esophagus

Yue Ming Zhang, David F. Boerwinkel, Xiumin Qin, Shun He, Liyan Xue, Bas L A M Weusten, Sanford M. Dawsey, David E. Fleischer, Li Zhou Dou, Yong Liu, Ning Lu, Jacques J G H M Bergman, Gui Qi Wang

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background and aim: Piecemeal endoscopic resection for esophageal high grade intraepithelial neoplasia (HGIN) or early squamous cell carcinoma (ESCC) is usually performed by cap-assisted endoscopic resection. This requires submucosal lifting and multiple snares. Multiband mucosectomy (MBM) uses a modified variceal band ligator without submucosal lifting. In high-risk areas where ESCC is common and endoscopic expertise is limited, MBM may be a better technique. We aimed to compare MBM to the cap-assisted technique for piecemeal endoscopic resection of esophageal ESCCs. Methods: Patients with mucosal HGIN/ESCC (2?–?6?cm, maximum two-thirds of esophageal circumference) were included. Lesions, delineated by 1.25?% Lugol staining, were randomized to MBM or cap-assisted piecemeal resection. Endpoints were procedure time and costs, complete endoscopic resection, adverse events, and absence of HGIN/ESCC at 3-month and 12-month follow-up. Results: Endoscopic resection was performed in 84 patients (59 men, mean age 60) using MBM (n?=?42) or the endoscopic resection cap (n?=?42). There were no differences in baseline characteristics. Endoscopic complete resection was achieved in all lesions. Procedure time was significantly shorter with MBM (11 vs. 22 minutes, P?

Original languageEnglish (US)
JournalEndoscopy
DOIs
StateAccepted/In press - Sep 16 2015

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Esophagus
Squamous Cell Carcinoma
Neoplasms
Staining and Labeling
Costs and Cost Analysis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A randomized trial comparing multiband mucosectomy and cap-assisted endoscopic resection for endoscopic piecemeal resection of early squamous neoplasia of the esophagus. / Zhang, Yue Ming; Boerwinkel, David F.; Qin, Xiumin; He, Shun; Xue, Liyan; Weusten, Bas L A M; Dawsey, Sanford M.; Fleischer, David E.; Dou, Li Zhou; Liu, Yong; Lu, Ning; Bergman, Jacques J G H M; Wang, Gui Qi.

In: Endoscopy, 16.09.2015.

Research output: Contribution to journalArticle

Zhang, YM, Boerwinkel, DF, Qin, X, He, S, Xue, L, Weusten, BLAM, Dawsey, SM, Fleischer, DE, Dou, LZ, Liu, Y, Lu, N, Bergman, JJGHM & Wang, GQ 2015, 'A randomized trial comparing multiband mucosectomy and cap-assisted endoscopic resection for endoscopic piecemeal resection of early squamous neoplasia of the esophagus', Endoscopy. https://doi.org/10.1055/s-0034-1393358
Zhang, Yue Ming ; Boerwinkel, David F. ; Qin, Xiumin ; He, Shun ; Xue, Liyan ; Weusten, Bas L A M ; Dawsey, Sanford M. ; Fleischer, David E. ; Dou, Li Zhou ; Liu, Yong ; Lu, Ning ; Bergman, Jacques J G H M ; Wang, Gui Qi. / A randomized trial comparing multiband mucosectomy and cap-assisted endoscopic resection for endoscopic piecemeal resection of early squamous neoplasia of the esophagus. In: Endoscopy. 2015.
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abstract = "Background and aim: Piecemeal endoscopic resection for esophageal high grade intraepithelial neoplasia (HGIN) or early squamous cell carcinoma (ESCC) is usually performed by cap-assisted endoscopic resection. This requires submucosal lifting and multiple snares. Multiband mucosectomy (MBM) uses a modified variceal band ligator without submucosal lifting. In high-risk areas where ESCC is common and endoscopic expertise is limited, MBM may be a better technique. We aimed to compare MBM to the cap-assisted technique for piecemeal endoscopic resection of esophageal ESCCs. Methods: Patients with mucosal HGIN/ESCC (2?–?6?cm, maximum two-thirds of esophageal circumference) were included. Lesions, delineated by 1.25?{\%} Lugol staining, were randomized to MBM or cap-assisted piecemeal resection. Endpoints were procedure time and costs, complete endoscopic resection, adverse events, and absence of HGIN/ESCC at 3-month and 12-month follow-up. Results: Endoscopic resection was performed in 84 patients (59 men, mean age 60) using MBM (n?=?42) or the endoscopic resection cap (n?=?42). There were no differences in baseline characteristics. Endoscopic complete resection was achieved in all lesions. Procedure time was significantly shorter with MBM (11 vs. 22 minutes, P?",
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AU - Boerwinkel, David F.

AU - Qin, Xiumin

AU - He, Shun

AU - Xue, Liyan

AU - Weusten, Bas L A M

AU - Dawsey, Sanford M.

AU - Fleischer, David E.

AU - Dou, Li Zhou

AU - Liu, Yong

AU - Lu, Ning

AU - Bergman, Jacques J G H M

AU - Wang, Gui Qi

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