Endoscopy 2019; 51(04): S48
DOI: 10.1055/s-0039-1681312
ESGE Days 2019 oral presentations
Friday, April 5, 2019 11:00 – 13:00: Video upper GI 2 South Hall 1B
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC BAND LIGATION WITHOUT RESECTION OF SMALL-SIZED SUBMUCOSAL TUMOURS: RESULTS IN SHORT-MEDIUM FOLLOW-UP TERM OF A MULTICENTER PROSPECTIVE STUDY (BANDING-SMT)

F Bas-Cutrina
1   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge – IDIBELL, Barcelona, Spain
,
CF Consiglieri
1   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge – IDIBELL, Barcelona, Spain
,
C Loras
2   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
,
X Andújar
2   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
,
C Huertas
3   Digestive Diseases Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
,
M Albert
3   Digestive Diseases Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
,
R Ballester
4   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
,
F González-Huix
4   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain
,
C Guarner-Argente
5   Endoscopy Unit, Digestive Diseases Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
,
A Pardo
6   Digestive Diseases Department, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain
,
J Bosch-Schips
7   Pathological Anatomy Department, Hospital Universitari de Bellvitge – IDIBELL, Barcelona, Spain
,
JB Gornals
1   Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge – IDIBELL, Barcelona, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

The endoscopic-band-ligation (EBL) without resection combined with a single-incision-needle-knife (SINK) biopsy is a little reported option in the management of submucosal-tumours (SMT). The main aim was to determine the efficacy of this technique. Secondary aims: to evaluate its safety and the diagnostic yield of biopsy.

Methods:

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

Results:

Sixty-four cases (44% of the sample calculation); EUS-control 4 – 6 weeks n = 51. Esophagus n = 3, stomach n = 49, duodenum n = 11, rectum n = 1. SMT medium-size: 9.5-mm (4.5 – 15 mm). EBL technical success: 87.5% (n = 56/64). Clinical success at 4 – 6 weeks: 92.2% (n = 47/51), overall clinical success: 79.7% (n = 47/59). SMT dependence of superficial vs. deep layer subanalysis: technical success 93% vs. 75%; overall clinical success 87% vs. 65%. SMT≤10-mm vs. > 10-mm: technical success 100% vs. 68%; overall clinical success 97% vs. 54%. Pathological diagnosis: 62.5% (30/48); no differences between SMT-size, SMT-layer, or number or biopsies. Two mild adverse events (3%): bleeding, pain. Incidences: epigastralgy (6h: 33%; 24 – 48h: 30%; 7-days: 14%; 4 – 6 weeks: 2%).

Tab. 1:

Technical and clinical success subanalysis

Superficial layer

Deep layer

SMT ≤10-mm

SMT > 10-mm

YES technical success

41 (93%)

15 (75%)

39 (100%)

17 (68%)

NO technical success

3 (7%)

5 (25%)

0 (0%)

8 (32%)

YES clinical success

34 (94%)

13 (87%)

34 (97%)

13 (81%)

Overall NO clinical success

5 (13%)

7 (35%)

1 (3%)

11 (46%)

Conclusions:

Preliminary results in the short-medium follow-up term indicate that EBL of small SMT, supplemented with SINK biopsy, seems to be a feasible and safe technique. The limitations of its technical and clinical success seem to be associated with the SMT size and deep layers dependence.