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• W2002117097 abstract "Background & Aims: Endoscopic resection (ER) of large early neoplastic lesions usually requires piece-meal resection. With the ER-cap technique this is a laborious procedure requiring repetitive submucosal injections and multiple snares. Multi-Band Mucosectomy (MBM) is a new technique that uses a modified variceal band ligator with multiple rubber bands (Duette™, Wilson-Cook Medical, Limerick, Ireland). Submucosal lifting and prelooping of the snare in the cap are not necessary and multiple resections can be performed with a single snare. We prospectively evaluated the feasibility of MBM for widespread ER in patients with a Barrett 's esophagus (BE) with high-grade intra-epithelial neoplasia (HGIN) or early cancer (EC). Methods: All piece-meal resections performed with the MBM were included and compared retrospectively with piece-meal ER-cap procedures, performed with a 12 mm cap. Results: 79 MBM procedures were performed in 39 pts (14 HGIN, 25 EC) and 84 cap procedures in 55 pts (27 HGIN, 28 EC). Mean BE length was 5 cm (SD 2.5) in the MBM group and 5 cm (SD 2.6) in the cap-group. A median of 5 pieces (IQR 3-7) were resected in the MBM-group in a median time of 35 min (IQR 27-60), vs. 5 pieces (IQR 2-6) in a median time of 45 min (IQR 33-67.5) for the cap group. The time/resection was 6.3 min (IQR 5-7.5) in the MBM group vs. 10.8 min (IQR 7.9-13.9) in the cap group (p = 0.002). Median diameter of the specimens was 16 mm (IQR 12-20) for MBM-specimens and 21 mm (IQR 18.5-25) for cap-specimens (p < 0.001), all resections involved the submucosa. There was one perforation in the cap group, successfully treated conservatively. Bleeding occurred in 5/79 (6%) of the MBM-procedures and in 16/84 (19%) of the cap-procedures (p = 0.02): all effectively treated endoscopically without a drop in hemoglobin levels. Technical difficulties during MBM-procedures included a decreased visibility due to the black bands covering the cap, and shifting of the wires into the field of view. Conclusions: MBM (Duette™) is a safe, easy and rapid method for resection of large areas in BE. Since submucosal lifting is not required and a single snare can be used, time and costs appear to be saved in comparison to the cap-technique. In addition, MBM appears to cause less bleeding during the ER procedure. MBM results in smaller sized specimens compared to the cap technique. Therefore, MBM is most suited for en-bloc resection of small lesions or for widespread resection of flat mucosa. With MBM the visibility is reduced compared to cap procedure, therefore a ‘pre-procedural plan’ is required.This research was financially supported by AstraZeneca BV, The Netherlands." @default.
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• W2002117097 date "2006-04-01" @default.
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• W2002117097 title "Widespread Mucosal Resection in Barrett's Esophagus Using Multi-Band Mucosectomy: Feasibility Study of 79 Procedures" @default.
• W2002117097 doi "https://doi.org/10.1016/j.gie.2006.03.564" @default.
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