Multiband mucosectomy for advanced dysplastic lesions in the upper digestive tract  

作　　者：Jesús Espinel Eugenia Pinedo Vanesa Ojeda Maria Guerra del Rio 

机构地区：[1]Department of Digestive Diseases,Hospital Universitario de León [2]Department of Radiodiagnosis,Hospital Universitario de León [3]Department of Digestive Diseases,Hospital Universitario Dr.Negrín,Las Palmas de Gran Canaria,35010, Spain [4]Burton Hospitals NHS Foundation Trust, Burton on Trent

出　　处：《World Journal of Gastrointestinal Endoscopy》2015年第4期370-380,共11页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：Endoscopic resection(ER) is at present an accepted treatment for superficial gastrointestinal neoplasia. ER provides similar efficacy to surgery; however, it is minimally invasive and less expensive. Endoscopic mucosal resection(EMR) is superior to biopsy for diagnosing advanced dysplasia and can change the diagnostic grade and the management. Several EMR techniques have been described that are alternatively used dependent upon the endoscopist personal experience, the anatomic conditions and the endoscopic appearance of the lesion to be resected. The literature suggests that EMR offers comparable outcomes to surgery for selected indications. EMR techniques using a cap fitted endoscope and EMR using a ligation device [multiband mucosectomy(MBM)] are the most frequently use. MBM technique does not require submucosal injection as with the endoscopic resectioncap technique, multiple resections can be performed with the same snare, pre-looping the endoscopic resection-snare in the ridge of the cap is not necessary, MBM does not require withdrawal of the endoscope between resections and up to six consecutive resections can be performed. This reduces the time and cost required for the procedure, while also reducing patient discomfort. Despite the increasing popularity of MBM, data on the safety and efficacy of this technique in upper gastrointestinal lesions with advanced dysplasia, defined as those lesions that have high-grade dysplasia or early cancer, is limited.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.

关 键 词：ENDOSCOPIC mucosal RESECTION Barrett'sesophagus Esophageal CANCER Early gastric CANCER Stepwise radical ENDOSCOPIC RESECTION Multibandmucosectomy ENDOSCOPIC SUBMUCOSAL dissection 

分 类 号：R656[医药卫生—外科学]