Endoscopic Band Ligation Without Resection Of Small-Sized Subepithelial Tumours: Results In Long-Term Follow Up Of A Multicentre Prospective Study (Banding-Set)

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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Artikel online veröffentlicht:
19. März 2021