Premium
Clinical value of multiband mucosectomy for the treatment of squamous intraepithelial neoplasia of the esophagus
Author(s) -
Jin XiFeng,
Sun QingYan,
Chai TongHai,
Li Shuhui,
Guo Yanli
Publication year - 2013
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12111
Subject(s) - medicine , esophagus , intraepithelial neoplasia , dysplasia , biopsy , surgery , confidence interval , endoscopy , esophageal cancer , radiology , cancer , prostate
Background and Aim To evaluate the clinical value of multiband mucosectomy ( MBM ) for the treatment of squamous intraepithelial neoplasia of the esophagus. Methods A total of 51 lesions located at esophagus from 43 patients were treated with MBM , among which 11 were diagnosed as middle‐grade intraepithelial neoplasia, 25 as high‐grade intraepithelial neoplasia, and 15 as early esophageal cancer pathologically. Primary end‐points were the rate of complete endoscopic resection and the mean operation time; the second end‐points were the postoperative local recurrence rate and acute plus early complications. The histopathological results were compared between pre‐ MBM biopsy and MBM specimens. All patients were followed up endoscopically. Results A total of 52 MBM procedures with 180 resections were performed in 43 patients. The complete endoscopic resection was achieved in 92.3% (95% confidence interval [ CI ] 81.8–96.9%). The sizes of the lesions ranged from 10 × 8 mm to 25 × 23 mm. The mean operation time is 37 ± 5 min. The operative acute bleeding complication was 7.6% (95% CI 3–18.1%); no perforations occurred. Early complications consisted of delayed bleeding (one patient 1.9%; 95% CI 0.3–10.1%) and slight esophageal stenosis (one patient). The histopathological diagnosis of 26 cases (51%) was consistent between biopsy and MBM samples, while 20 lesions exhibited higher grade dysplasia. The local recurrence rate was 6.9% (3/43) at 1 year, 9.3% (4/43) at 2 years, and 9.3% at 2.5 years. No death occurred during follow‐up. Conclusions MBM is a safe and effective technique for the treatment of early esophageal cancer and precancerous lesions.