A prospective multicenter study using a new multiband mucosectomy device for endoscopic resection of early neoplasia in Barrett's esophagus
Autor: | Rehan Haidry, Oliver Pech, Jacques J. Bergman, Erik J. Schoon, Jacobo Ortiz-Fernández-Sordo, Massimiliano DiPietro, Cadman L. Leggett, Rachel Heise-Ginsburg, Nicholas J. Shaheen, Roos E. Pouw, Arjun D. Koch, Anniek W. Gotink, Bas L. Weusten, Kenneth K. Wang, Michael B. Wallace, Kamar Belghazi, Krish Ragunath, Norman E. Marcon, Horst Neuhaus, Torsten Beyna, Raf Bisschops |
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Přispěvatelé: | Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and hepatology, Gastroenterology and Hepatology, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, Graduate School, Gastroenterology & Hepatology |
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Endoscopic Mucosal Resection Esophageal Neoplasms Perforation (oil well) Operative Time Adenocarcinoma Postoperative Hemorrhage Suction 03 medical and health sciences Barrett Esophagus 0302 clinical medicine Interquartile range medicine Clinical endpoint Humans Radiology Nuclear Medicine and imaging Prospective Studies Esophagus Prospective cohort study Aged Esophageal Perforation Science & Technology Gastroenterology & Hepatology business.industry Gastroenterology Middle Aged medicine.disease Dysphagia RANDOMIZED-TRIAL Surgery medicine.anatomical_structure Dysplasia 030220 oncology & carcinogenesis Barrett's esophagus 030211 gastroenterology & hepatology Female Esophagoscopy medicine.symptom business Deglutition Disorders Life Sciences & Biomedicine |
Zdroj: | Gastrointestinal Endoscopy, 88(4), 647-654. Mosby Inc. Gastrointestinal endoscopy, 88(4), 647-654. Mosby Inc. Pouw, R E, Beyna, T, Belghazi, K, Koch, A D, Schoon, E J, Haidry, R, Weusten, B L, Bisschops, R, Shaheen, N J, Wallace, M B, Marcon, N, Heise-Ginsburg, R, Gotink, A W, Wang, K K, Leggett, C L, Ortiz-Fernández-Sordo, J, Ragunath, K, DiPietro, M, Pech, O, Neuhaus, H & Bergman, J J 2018, ' A prospective multicenter study using a new multiband mucosectomy device for endoscopic resection of early neoplasia in Barrett's esophagus ', Gastrointestinal Endoscopy, vol. 88, no. 4, pp. 647-654 . https://doi.org/10.1016/j.gie.2018.06.030 |
ISSN: | 0016-5107 |
Popis: | BACKGROUND AND AIMS: Early neoplasia in Barrett's esophagus (BE) can be effectively and safely removed by endoscopic resection (ER) using multiband mucosectomy (MBM). This study aimed to document performance of a novel MBM device designed for improved visualization, easier passage of accessories, and better suction power compared with other marketed MBM devices. METHODS: This international, single-arm, prospective registry in 14 referral centers (Europe, 10; United States, 3; Canada, 1) included patients with early BE neoplasia scheduled for ER. The primary endpoint was successful ER defined as complete resection of the delineated area in 1 procedure. Secondary outcomes were adverse events and procedure time. RESULTS: A total of 332 lesions was included in 291 patients (248 men; mean age, 67 years [standard deviation, 9.6]). ER indication was high-grade dysplasia in 64%, early adenocarcinoma in 19%, lesion with low-grade dysplasia in 11%, and a lesion without definite histology in 6%. Successful ER was reached in 322 of 332 lesions (97%; 95% confidence interval [CI], 94.6%-98.4%). A perforation occurred in 3 of 332 procedures (.9%; 95% CI, .31%-2.62%), all were managed endoscopically, and patients were admitted with intravenous antibiotics during days 2, 3, and 9. Postprocedural bleeding requiring an intervention occurred in 5 of 332 resections (1.5%; 95% CI, .65%-3.48%). Dysphagia requiring dilatation occurred in 11 patients (3.8%; 95% CI, 2.1%-6.6%). Median procedure time was 16 minutes (interquartile range, 12.0-26.0). CONCLUSIONS: In expert hands, the novel MBM device proved to be effective for resection of early neoplastic lesions in BE, with successful ER in 97% of procedures. Severe adverse events were rare and were effectively managed endoscopically or conservatively. (Clinical trial registration number: NCT02482701.). ispartof: GASTROINTESTINAL ENDOSCOPY vol:88 issue:4 pages:647-654 ispartof: location:United States status: published |
Databáze: | OpenAIRE |
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