Endoscopic band ligation without resection in selected patients for small and superficial upper gastrointestinal tract lesions
-
Gemma Ibáñez-Sanz [2] ; Joan B. Gornals [2] ; Laura Rivas [2] ; Sílvia Salord [2] ; María José Paúles [2] ; Josep M. Botargues [2] ; Maica Galán [1]
-
[1] Institute Catalá Oncología
Institute Catalá Oncología
Barcelona, España
-
[2] Hospital Universitari de Bellvitge-IDIBELL. L’Hospitalet de Llobregat, Barcelona. Spain
-
- Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 108, Nº. 5, 2016, págs. 250-256
- Idioma: inglés
- Enlaces
-
Resumen
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.
