Year 2016 / Volume 108 / Number 5
Original
Endoscopic band ligation without resection in selected patients for small and superficial upper gastrointestinal tract lesions

250-256

DOI: 10.17235/reed.2016.4031/2015

Gemma Ibáñez-Sanz, Joan B. Gornals, Laura Rivas, Sílvia Salord, María José Paúles, Josep M. Botargues, Maica Galán,

Abstract
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.
New comment
Comments
No comments for this article
References
1. Bourke MJ. Endoscopic resection in the duodenum: current limitations and future directions. Endoscopy 2013; 45: 127–32
2. Diaz-Cervantes E, De-la-Torre-Bravo A, Spechler SJ, et, al. Banding without resection (Endoscopic mucosal ligation) as a novel approach for the ablation of short-segment Barrett’s epithelium: Results of a pilot study. Am J Gastroenterol 2007; 102: 1640–45
3. Neumann H, Ramesh J, Wilcox CM, et al. Resection of carcinoids in the duodenal bulb using the band ligation technique with the Duettemucosectomy Device. Endoscopy 2013; 45: E365–66
4. Scherer JR, Holinga J, Saunders M, et al. Small duodenal carcinoids: a case series comparing endoscopic resection and autoamputation with band ligation. J Clin Gastroenterol. 2015; 49: 289-92
5. Lee SY, Hong YS, Lee JM, et al. Duodenal gastrinoma treated with endoscopic band ligation. Gastrointest Endosc 2009; 69: 964-67
6. Sun S, Jin Y, Chang G, et al. Endoscopic band ligation without electrosurgery: a new technique for excision of small upper-GI leiomyoma. Gastrointest Endosc 2004; 60: 218-22
7. Salord S, Gornals J, Galan M, et al. Band ligation of a T1 esophageal squamous cell cancer in a patient with multimorbidities. Endoscopy 2012; 44: E171-72
8. Hoffmann KM, Furukawa M, Jensen RT. Duodenal neuroendocrine tumors: Classification, functional syndromes, diagnosis and medical treatment. Best Pract Res Clin Gastroenterol 2005; 9: 675-97
9. Sun S, Ge N, Wang S, et al. EUS-assisted band ligation of small duodenal stromal tumors and follow-up by EUS. Gastrointest Endosc. 2009; 69: 492-96
10. Jeonh ID, Jung SW, Bang S, et al. Endoscopic enucleation for gastric subepithelial tumors originating in the muscularis propria layer. Surg Endosc 2011; 25:468–74
11. Park Y, Cho E, Kang HY, et al. The effectiveness and safety of endoscopic submucosal dissection compared with endoscopic mucosal resection for early gastric cancer: a systematic review and metaanalysis. Surg Endosc 2011; 25: 2666-77
12. Kim DU, Lee JH, Min BH, et al. Risk factors of lymph node metastasis in T1 esophageal squamous cell carcinoma. J Gastroenterol Hepatol 2008; 23: 619–25
13. Wang Z1, Ma L, Zhang XM, et al. Risk of lymph node metastases from early gastric cancer in relation to depth of invasion: experience in a single institution. Asian Pac J Cancer Prev. 2014; 15: 5371-75
14. Kachare SD, Liner KR, Vohra NA, et al. A modified duodenal neuroendocrine tumor staging schema better defines the risk of lymph node metastasis and disease-free survival. Am Surg. 2014; 80: 821-26
15. Lee DG, Kim GH, Park DY, et al. Endoscopic submucosal resection of esophageal subepithelial lesions using band ligation. Endoscopy 2011; 43: 822–5
Related articles

Letter

Endoscopic mucosal resection for cap poliposis treatment

DOI: 10.17235/reed.2020.6537/2019

Citation tools
Ibáñez-Sanz G, Gornals J, Rivas L, Salord S, Paúles M, Botargues J, et all. Endoscopic band ligation without resection in selected patients for small and superficial upper gastrointestinal tract lesions. 4031/2015


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 357 visits.
This article has been downloaded 83 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 04/10/2015

Accepted: 18/03/2016

Online First: 29/03/2016

Published: 29/04/2016

Article revision time: 159 days

Article Online First time: 177 days

Article editing time: 208 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2025 y Creative Commons. The Spanish Journal of Gastroenterology