Long-term outcomes of endoscopic multiband mucosectomy for early esophageal squamous cell neoplasia: a retrospective, single-center study

• Published in: Gastrointestinal endoscopy 2016-12, Vol.84 (6), p.893-899
• Main Authors: Wang, Zhenkai, MD, Lu, Heng, MD, Wu, Lin, MD, Yuan, Boshi, MD, Liu, Jiong, MD, Shi, Hui, MD, Wang, Fangyu, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Electrocoagulation; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophageal Perforation - etiology; Esophagoscopy; Feasibility Studies; Female; Follow-Up Studies; Gastroenterology and Hepatology; Humans; Male; Middle Aged; Mucous Membrane - surgery; Neoplasm Recurrence, Local - etiology; Neoplasm Recurrence, Local - surgery; Operative Time; Postoperative Complications - etiology; Retrospective Studies; Time Factors
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2016.04.015

Background and Aims Endoscopic multiband mucosectomy (EMBM) has been used to treat early Barrett’s esophagus and esophagogastric junction neoplasia, yet it is seldom reported for the treatment of early esophageal squamous cell neoplasia. Here we retrospectively evaluated the feasibility, safety, and efficacy of EMBM for early esophageal squamous cell neoplasia. Methods A total of 125 patients were included in the study. Lesions were delineated using electrocoagulation and resected using the EMBM technique. The primary outcomes were local recurrence and adverse events. Secondary outcomes were histology of the endoscopic resection specimens, specimen area, and speed of resection. All patients were followed up endoscopically. Results There were 135 esophageal lesions, of which 40 were pathologically diagnosed as low-grade intraepithelial neoplasia, 57 as high-grade intraepithelial neoplasia, 34 as early esophageal cancer, and 4 as squamous epithelium without neoplasia. No severe adverse events were observed, except for 1 perforation, which was treated by application of clips. The median follow-up was 27.75 months. Three patients had local recurrence and were endoscopically treated again. Local recurrence rate was 2.4% (3/125). No deaths occurred during the follow-up. All specimens were visible with a dividing rule, and the mean specimen area was 4.63 cm2 . Mean operation time was 31.2 ± 17.4 minutes. Mean speed of resection was 6.74 min/cm2. Conclusions EMBM seems to be effective and safe for patients with early esophageal squamous cell neoplasia. The long-term recurrence rate is low.