Multiband mucosectomy for advanced dysplastic lesions inthe upper digestive tract

• 作者: Jesús Espinel Eugenia Pinedo Vanesa Ojeda Maria Guerra del Rio
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: ENDOSCOPIC mucosal RESECTION Barrett'sesophagus Esophageal CANCER Early gastric CANCER Stepwise radical ENDOSCOPIC RESECTION Multibandmucosectomy ENDOSCOPIC submucosal dissection
• 年，卷（期）: 2015,（4）
• 页码范围: 370-380
• 页数: 11页
• 分类号: R

摘要

Endoscopic resection （ER） is at present an acceptedtreatment for superficial gastrointestinal neoplasia.ER provides similar efficacy to surgery; however, itis minimally invasive and less expensive. Endoscopicmucosal resection （EMR） is superior to biopsy fordiagnosing advanced dysplasia and can change thediagnostic grade and the management. Several EMRtechniques have been described that are alternativelyused dependent upon the endoscopist personalexperience, the anatomic conditions and the endoscopicappearance of the lesion to be resected. The literaturesuggests that EMR offers comparable outcomes tosurgery for selected indications. EMR techniquesusing a cap fitted endoscope and EMR using a ligationdevice [multiband mucosectomy （MBM）] are themost frequently use. MBM technique does not requiresubmucosal injection as with the endoscopic resectioncaptechnique, multiple resections can be performedwith the same snare, pre-looping the endoscopicresection-snare in the ridge of the cap is not necessary,MBM does not require withdrawal of the endoscopebetween resections and up to six consecutive resectionscan be performed. This reduces the time and costrequired for the procedure, while also reducing patientdiscomfort. Despite the increasing popularity of MBM,data on the safety and efficacy of this technique inupper gastrointestinal lesions with advanced dysplasia,defined as those lesions that have high-grade dysplasiaor early cancer, is limited.