Endoscopy 2021; 53(S 01): S87-S88
DOI: 10.1055/s-0041-1724476
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Endoscopic Band Ligation Without Resection Of Small-Sized Subepithelial Tumours: Results In Long-Term Follow Up Of A Multicentre Prospective Study (Banding-Set)

F Bas-Cutrina
1   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain
,
C Loras
2   Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Catalonia, Spain
,
A Pardo
3   Department of Digestive Diseases, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Catalonia, Spain
,
R Ballester-Clau
4   Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Catalonia, Spain
,
C Huertas
5   Department of Digestive Diseases, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Catalonia, Spain
,
C Guarner-Argente
6   Endoscopy Unit, Digestive Pathology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
,
J Colán-Hernández
7   Department of Digestive Diseases, Hospital Universitari Germans Trias i Pujol (Can Ruti), Badalona, Barcelona, Catalonia, Spain
,
CF Consiglieri
1   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain
,
X Andujar
8   Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Catalonia., Spain
,
M Vilanova-Serra
3   Department of Digestive Diseases, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Catalonia, Spain
,
F González-Huix
9   Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Catalonia., Spain
,
L Pardo-Grau
5   Department of Digestive Diseases, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Catalonia, Spain
,
S Maisterra
10   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Catalonia., Spain
,
P Ruiz-Ramírez
8   Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Catalonia., Spain
,
A Garcia-Sumalla
10   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Catalonia., Spain
,
JB Gornals
10   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Catalonia., Spain
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    Aims Endoscopic band ligation (EBL) without resection combined with a single-incision needle-knife (SINK) biopsy is a little reported option in the management of subepithelial tumours (SET). The main aim was to determine the effectiveness of this technique in small-sized SETs: technical and clinical success, diagnostic yield of biopsy, involvement in clinical management, and associated adverse events.

    Methods Prospective multicentre study. Inclusion criteria: SET ≤15-mm, confirmed by endoscopic ultrasound (EUS). Technical success: complete EBL of the SET plus SINK biopsy. Clinical success: SET total disappearance. Clinical controls: recovery at first 6 hours, calling at 48 hours and 7 days. EUS control at 4-6 weeks and 12 months. ClinicalTrials.gov register: NCT03247231.

    Results Seven centres, including 122 cases; control 4-6 weeks n = 121; control 12 months n = 90. Esophagus n = 7, stomach n = 94, duodenum n = 20, rectum n = 1. SET medium size: 9-mm (3.5-15 mm). Technical success: 86.9 % (n = 106/122). Clinical success 4-6w: 77.7 % (n = 94/121); 12m: 61.8 % (n = 56/90). Implication in changing SET clinical management: 79.4 % (n = 85/107). SET ≤10-mm vs. >10-mm subanalysis: technical success 96.4 vs. 66.7 %; clinical success 4-6w 91.6 vs. 44.7 %; 12m 83.3 vs. 30.6 %; clinical management change 91.4 vs. 56.8 %. SET dependence of superficial vs. deep layer subanalysis: technical success 91 vs. 79.6 %; clinical success 4-6w 80.8 vs. 69.8 %; 12m 68.3 vs. 48.2 %; clinical management change 84.5 vs. 69.4 %. Pathological diagnosis: 66 % (n = 62/94). Six mild adverse events (4.9 %), 5 related to the technique (4.1 %): bleeding (n-2), pain (n-2), mucosal laceration; one not directly related to it (0.8 %): bronchoaspiration by sedation.

    Tab. 1

    SET ≤10-mm

    SET >10-mm

    Superficial layer

    Deep layer

    Technical success YES

    80/83 (96.4 %)

    26/39 (66.7 %)

    71/78 (91.0 %)

    35/44 (79.6 %)

    Clinical success 4-6w YES

    76/83 (91.6 %)

    17/38 (44.7 %)

    63/78 (80.8 %)

    30/43 (69.8 %)

    Clinical success 12m YES

    45/54 (83.3 %)

    11/36 (30.6 %)

    43/63 (68.3 %)

    13/27 (48.2 %)

    Clinical management change YES

    64/70 (91.4 %)

    21/37 (56.8 %)

    60/71 (84.5 %)

    25/36 (69.4 %)

    Conclusions EBL without resection supplemented with SINK biopsy is a feasible and safe endoscopic technique in small-sized SETs. Technical limitations and clinical success are associated with the SET size and deep layers depencende. In SETs not exceeding 10-mm and depending on superficial gastrointestinal layers is where the technique has a greater impact on its clinical management.

    Citation: Bas-Cutrina F, Loras C, Pardo A et al. OP212 ENDOSCOPIC BAND LIGATION WITHOUT RESECTION OF SMALL-SIZED SUBEPITHELIAL TUMOURS: RESULTS IN LONG-TERM FOLLOW UP OF A MULTICENTRE PROSPECTIVE STUDY (BANDING-SET). Endoscopy 2021; 53: S87.


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    Publication History

    Article published online:
    19 March 2021

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