Prospective feasibility study on the use of multiband mucosectomy for endoscopic resection of early squamous neoplasia in the esophagus

Y. M. Zhang, D. F. Boerwinkel, S. He, B. L A M Weusten, L. Y. Xue, D. E. Fleischer, N. Lu, S. M. Dawsey, S. M. Zuo, X. M. Qin, L. Z. Dou, J. J G H M Bergman, G. Q. Wang

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background and study aims: Endoscopic resection for esophageal squamous high-grade intraepithelial neoplasia (HGIN) or intramucosal cancer (esophageal squamous cell carcinoma [ESCC]) with the endoscopic resection cap technique is technically difficult, and requires submucosal lifting and multiple snares for piecemeal resections. Multiband mucosectomy (MBM) is an easy-to-use endoscopic resection technique and may be the modality of choice in China, where ESCC is extremely prevalent. The aim of the current study was to prospectively evaluate MBM for piecemeal endoscopic resection of squamous neoplasia of the esophagus. Methods: Patients with HGIN/ESCC and no signs of submucosal invasion or metastatic disease were included in the study. Lesions were delineated using electrocoagulation and resected using the MBM technique. Endpoints were procedure time, endoscopic radicality, complications, histology of the endoscopic resection specimens, and absence of HGIN/ESCC at the endoscopic resection scar during follow-up. Results: A total of 41 patients (26 male; mean age 61 years) underwent MBM; all lesions were visible with white light endoscopy (median length 5 cm, interquartile range [IQR] 4 - 6 cm; median circumferential extent 42 %, IQR 25 - 50 %). Median procedure time was 12 minutes (IQR 8 - 24 minutes). Median number of resections was 5 (IQR 3 - 6). Endoscopic complete resection was achieved in all lesions. There was one perforation, which was treated by application of clips. No other complications were observed. The worst histology was ESCC (n = 19), HGIN (n = 17), middle grade intraepithelial neoplasia (n = 4), and normal squamous epithelium (n = 1). Endoscopic follow-up at 3 months showed HGIN at the endoscopic resection scar in two patients, which was effectively treated endoscopically, and showed normal squamous epithelium in all patients at final follow-up (median 15 months, IQR 12 - 24 months). Conclusion: This first prospective study on MBM for piecemeal endoscopic resection of early esophageal squamous neoplasia showed that MBM was effective for the complete removal of lesions with short procedure time, few complications, effective histological assessment of resected specimens, and durable treatment effect.

Original languageEnglish (US)
Pages (from-to)167-173
Number of pages7
JournalEndoscopy
Volume45
Issue number3
DOIs
StatePublished - 2013

Fingerprint

Feasibility Studies
Esophagus
Prospective Studies
Neoplasms
Cicatrix
Histology
Epithelium
Electrocoagulation
Surgical Instruments
Endoscopy
China
Esophageal Squamous Cell Carcinoma
Light

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Zhang, Y. M., Boerwinkel, D. F., He, S., Weusten, B. L. A. M., Xue, L. Y., Fleischer, D. E., ... Wang, G. Q. (2013). Prospective feasibility study on the use of multiband mucosectomy for endoscopic resection of early squamous neoplasia in the esophagus. Endoscopy, 45(3), 167-173. https://doi.org/10.1055/s-0032-1326011

Prospective feasibility study on the use of multiband mucosectomy for endoscopic resection of early squamous neoplasia in the esophagus. / Zhang, Y. M.; Boerwinkel, D. F.; He, S.; Weusten, B. L A M; Xue, L. Y.; Fleischer, D. E.; Lu, N.; Dawsey, S. M.; Zuo, S. M.; Qin, X. M.; Dou, L. Z.; Bergman, J. J G H M; Wang, G. Q.

In: Endoscopy, Vol. 45, No. 3, 2013, p. 167-173.

Research output: Contribution to journalArticle

Zhang, YM, Boerwinkel, DF, He, S, Weusten, BLAM, Xue, LY, Fleischer, DE, Lu, N, Dawsey, SM, Zuo, SM, Qin, XM, Dou, LZ, Bergman, JJGHM & Wang, GQ 2013, 'Prospective feasibility study on the use of multiband mucosectomy for endoscopic resection of early squamous neoplasia in the esophagus', Endoscopy, vol. 45, no. 3, pp. 167-173. https://doi.org/10.1055/s-0032-1326011
Zhang, Y. M. ; Boerwinkel, D. F. ; He, S. ; Weusten, B. L A M ; Xue, L. Y. ; Fleischer, D. E. ; Lu, N. ; Dawsey, S. M. ; Zuo, S. M. ; Qin, X. M. ; Dou, L. Z. ; Bergman, J. J G H M ; Wang, G. Q. / Prospective feasibility study on the use of multiband mucosectomy for endoscopic resection of early squamous neoplasia in the esophagus. In: Endoscopy. 2013 ; Vol. 45, No. 3. pp. 167-173.
@article{923756e56d634654ab5c2054dcf798df,
title = "Prospective feasibility study on the use of multiband mucosectomy for endoscopic resection of early squamous neoplasia in the esophagus",
abstract = "Background and study aims: Endoscopic resection for esophageal squamous high-grade intraepithelial neoplasia (HGIN) or intramucosal cancer (esophageal squamous cell carcinoma [ESCC]) with the endoscopic resection cap technique is technically difficult, and requires submucosal lifting and multiple snares for piecemeal resections. Multiband mucosectomy (MBM) is an easy-to-use endoscopic resection technique and may be the modality of choice in China, where ESCC is extremely prevalent. The aim of the current study was to prospectively evaluate MBM for piecemeal endoscopic resection of squamous neoplasia of the esophagus. Methods: Patients with HGIN/ESCC and no signs of submucosal invasion or metastatic disease were included in the study. Lesions were delineated using electrocoagulation and resected using the MBM technique. Endpoints were procedure time, endoscopic radicality, complications, histology of the endoscopic resection specimens, and absence of HGIN/ESCC at the endoscopic resection scar during follow-up. Results: A total of 41 patients (26 male; mean age 61 years) underwent MBM; all lesions were visible with white light endoscopy (median length 5 cm, interquartile range [IQR] 4 - 6 cm; median circumferential extent 42 {\%}, IQR 25 - 50 {\%}). Median procedure time was 12 minutes (IQR 8 - 24 minutes). Median number of resections was 5 (IQR 3 - 6). Endoscopic complete resection was achieved in all lesions. There was one perforation, which was treated by application of clips. No other complications were observed. The worst histology was ESCC (n = 19), HGIN (n = 17), middle grade intraepithelial neoplasia (n = 4), and normal squamous epithelium (n = 1). Endoscopic follow-up at 3 months showed HGIN at the endoscopic resection scar in two patients, which was effectively treated endoscopically, and showed normal squamous epithelium in all patients at final follow-up (median 15 months, IQR 12 - 24 months). Conclusion: This first prospective study on MBM for piecemeal endoscopic resection of early esophageal squamous neoplasia showed that MBM was effective for the complete removal of lesions with short procedure time, few complications, effective histological assessment of resected specimens, and durable treatment effect.",
author = "Zhang, {Y. M.} and Boerwinkel, {D. F.} and S. He and Weusten, {B. L A M} and Xue, {L. Y.} and Fleischer, {D. E.} and N. Lu and Dawsey, {S. M.} and Zuo, {S. M.} and Qin, {X. M.} and Dou, {L. Z.} and Bergman, {J. J G H M} and Wang, {G. Q.}",
year = "2013",
doi = "10.1055/s-0032-1326011",
language = "English (US)",
volume = "45",
pages = "167--173",
journal = "Endoscopy",
issn = "0013-726X",
publisher = "Georg Thieme Verlag",
number = "3",

}

TY - JOUR

T1 - Prospective feasibility study on the use of multiband mucosectomy for endoscopic resection of early squamous neoplasia in the esophagus

AU - Zhang, Y. M.

AU - Boerwinkel, D. F.

AU - He, S.

AU - Weusten, B. L A M

AU - Xue, L. Y.

AU - Fleischer, D. E.

AU - Lu, N.

AU - Dawsey, S. M.

AU - Zuo, S. M.

AU - Qin, X. M.

AU - Dou, L. Z.

AU - Bergman, J. J G H M

AU - Wang, G. Q.

PY - 2013

Y1 - 2013

N2 - Background and study aims: Endoscopic resection for esophageal squamous high-grade intraepithelial neoplasia (HGIN) or intramucosal cancer (esophageal squamous cell carcinoma [ESCC]) with the endoscopic resection cap technique is technically difficult, and requires submucosal lifting and multiple snares for piecemeal resections. Multiband mucosectomy (MBM) is an easy-to-use endoscopic resection technique and may be the modality of choice in China, where ESCC is extremely prevalent. The aim of the current study was to prospectively evaluate MBM for piecemeal endoscopic resection of squamous neoplasia of the esophagus. Methods: Patients with HGIN/ESCC and no signs of submucosal invasion or metastatic disease were included in the study. Lesions were delineated using electrocoagulation and resected using the MBM technique. Endpoints were procedure time, endoscopic radicality, complications, histology of the endoscopic resection specimens, and absence of HGIN/ESCC at the endoscopic resection scar during follow-up. Results: A total of 41 patients (26 male; mean age 61 years) underwent MBM; all lesions were visible with white light endoscopy (median length 5 cm, interquartile range [IQR] 4 - 6 cm; median circumferential extent 42 %, IQR 25 - 50 %). Median procedure time was 12 minutes (IQR 8 - 24 minutes). Median number of resections was 5 (IQR 3 - 6). Endoscopic complete resection was achieved in all lesions. There was one perforation, which was treated by application of clips. No other complications were observed. The worst histology was ESCC (n = 19), HGIN (n = 17), middle grade intraepithelial neoplasia (n = 4), and normal squamous epithelium (n = 1). Endoscopic follow-up at 3 months showed HGIN at the endoscopic resection scar in two patients, which was effectively treated endoscopically, and showed normal squamous epithelium in all patients at final follow-up (median 15 months, IQR 12 - 24 months). Conclusion: This first prospective study on MBM for piecemeal endoscopic resection of early esophageal squamous neoplasia showed that MBM was effective for the complete removal of lesions with short procedure time, few complications, effective histological assessment of resected specimens, and durable treatment effect.

AB - Background and study aims: Endoscopic resection for esophageal squamous high-grade intraepithelial neoplasia (HGIN) or intramucosal cancer (esophageal squamous cell carcinoma [ESCC]) with the endoscopic resection cap technique is technically difficult, and requires submucosal lifting and multiple snares for piecemeal resections. Multiband mucosectomy (MBM) is an easy-to-use endoscopic resection technique and may be the modality of choice in China, where ESCC is extremely prevalent. The aim of the current study was to prospectively evaluate MBM for piecemeal endoscopic resection of squamous neoplasia of the esophagus. Methods: Patients with HGIN/ESCC and no signs of submucosal invasion or metastatic disease were included in the study. Lesions were delineated using electrocoagulation and resected using the MBM technique. Endpoints were procedure time, endoscopic radicality, complications, histology of the endoscopic resection specimens, and absence of HGIN/ESCC at the endoscopic resection scar during follow-up. Results: A total of 41 patients (26 male; mean age 61 years) underwent MBM; all lesions were visible with white light endoscopy (median length 5 cm, interquartile range [IQR] 4 - 6 cm; median circumferential extent 42 %, IQR 25 - 50 %). Median procedure time was 12 minutes (IQR 8 - 24 minutes). Median number of resections was 5 (IQR 3 - 6). Endoscopic complete resection was achieved in all lesions. There was one perforation, which was treated by application of clips. No other complications were observed. The worst histology was ESCC (n = 19), HGIN (n = 17), middle grade intraepithelial neoplasia (n = 4), and normal squamous epithelium (n = 1). Endoscopic follow-up at 3 months showed HGIN at the endoscopic resection scar in two patients, which was effectively treated endoscopically, and showed normal squamous epithelium in all patients at final follow-up (median 15 months, IQR 12 - 24 months). Conclusion: This first prospective study on MBM for piecemeal endoscopic resection of early esophageal squamous neoplasia showed that MBM was effective for the complete removal of lesions with short procedure time, few complications, effective histological assessment of resected specimens, and durable treatment effect.

UR - http://www.scopus.com/inward/record.url?scp=84874457143&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874457143&partnerID=8YFLogxK

U2 - 10.1055/s-0032-1326011

DO - 10.1055/s-0032-1326011

M3 - Article

C2 - 23258547

AN - SCOPUS:84874457143

VL - 45

SP - 167

EP - 173

JO - Endoscopy

JF - Endoscopy

SN - 0013-726X

IS - 3

ER -