Endoscopy 2006; 38(10): 1029-1031
DOI: 10.1055/s-2006-944527
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic mucosal resection of early esophageal squamous cell cancer using the Duette mucosectomy kit

S.  Seewald1 , T.  L.  Ang1 , S.  Omar1 , S.  Groth1 , F.  Dy1 , Y.  Zhong1 , U.  Seitz1 , F.  Thonke1 , E.  Yekebas2 , J.  Izbicki2 , N.  Soehendra1
  • 1Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Germany
  • 2Department of Surgery, University Medical Center Hamburg-Eppendorf, Germany
Further Information

Publication History

Submitted 21 December 2005

Accepted after revision 4 April 2006

Publication Date:
20 October 2006 (online)

Background and study aim: Endoscopic mucosal resection (EMR) is a less invasive alternative treatment strategy to surgery for intramucosal esophageal squamous cell carcinoma (SCC). This study described our initial experience with the newly introduced Duette Multiband Mucosectomy Kit (Cook Ireland Ltd, Limerick, Ireland) for the treatment of extensive early esophageal SCC.
Patients and methods: Five patients with extensive early esophageal SCC, covering at least half of the circumference of the esophageal wall and measuring a mean of 2.8 cm longitudinally, underwent EMR after EUS staging.
Results: EMR was successfully completed in one session in five patients. Post-EMR stricture occurred in four patients but was successfully treated with bougienage. One patient did not return for follow-up after bougienage and died from ischemic heart disease 3 months later. For the remaining four patients, there was no recurrence over a mean follow up of 14.7 months.
Conclusion: This new device obviates the need for repeated insertion of the endoscope during the process of ligation and resection and thus facilitates EMR of extensive SCC.

References

  • 1 Kodama M, Kakegawa T. Treatment of superficial cancer of the esophagus: a summary of responses to a questionnaire on superficial cancer of the esophagus in Japan.  Surgery. 1998;  123 432-439
  • 2 Rembacken B J, Gotoda T, Fujii T. et al . Endoscopic mucosal resection.  Endoscopy. 2001;  33 709-718
  • 3 Pech O, Gossner L, May A. et al . Endoscopic resection of superficial esophageal squamous cell carcinomas: western experience.  Am J Gastroenterol. 2004;  99 1226-1232
  • 4 Chaves D M, Sakai P, Mester M. et al . A new endoscopic technique for the resection of flat polypoid lesions.  Gastrointest Endosc. 1994;  40 224-226
  • 5 Soehendra N, Seewald S, Groth S. et al . Use of modified multiband ligator facilitates circumferential endoscopic mucosal resection in Barrett’s esophagus.  Gastrointest Endosc. 2006;  63 847-852
  • 6 Inoue H, Takeshita K, Hori H. et al . Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach and colon mucosal lesions.  Gastrointest Endosc. 1993;  39 58-62
  • 7 May A, Gossner L, Behrens A. et al . A prospective randomized trial of two different endoscopic resection techniques for early cancer of the esophagus.  Gastrointest Endosc. 2003;  58 167-175
  • 8 Momma K. Endoscopic mucosal resection for early esophageal cancer: standard indications.  Endoscopia Digestiva. 2002;  14 1717-1718
  • 9 Ohkuwa M, Hosokawa K, Boku N. et al . New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife.  Endoscopy. 2001;  33 221-226
  • 10 Rösch T, Sarbia M, Schumacher B. et al . Attempted en bloc resection of mucosal and submucosal tumors using insulated-tip knives: a pilot series.  Endoscopy. 2004;  36 788-801
  • 11 Oyama T, Tomori A, Hotta K. et al . Endoscopic submucosal dissection of early esophageal cancer.  Clin Gastroenterol Hepatol. 2005;  3 Suppl 1 S67-S70

S. Seewald, M. D.

Department of Interdisciplinary Endoscopy

University Medical Centre Hamburg-Eppendorf · Martinistraße 52 · 20246 Hamburg · Germany

Fax: +49-40-428034420 ·

Email: seewald@uke.uni-hamburg.de