Endoscopy 2008; 40(5): 395-399
DOI: 10.1055/s-2007-995529
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Depth of resection using two different endoscopic mucosal resection techniques

J.  A.  Abrams1 , P.  Fedi1 , E.  Vakiani2 , D.  Hatefi3 , H.  E.  Remotti4 , C.  J.  Lightdale1
  • 1Department of Medicine, Columbia University Medical Center, New York, NY, USA
  • 2Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  • 3Georgetown University School of Medicine, Washington, DC, USA
  • 4Department of Surgical Pathology, Columbia University Medical Center, New York, NY, USA
Further Information

Publication History

submitted 25 April 2007

accepted after revision 16 November 2007

Publication Date:
12 March 2008 (online)

Background and study aims: Endoscopic mucosal resection (EMR) has been carried out for high-grade dysplasia (HGD) and intramucosal carcinoma (IMCA) in Barrett’s esophagus using two different cap-assisted techniques, the ”inject, suck, and cut“ and the ”band and snare.“ Previous work has demonstrated comparable specimen diameters. However, the two techniques have not been previously compared with respect to depth of resection.

Patients and methods: From a database of patients with Barrett’s esophagus, we identified 40 consecutive specimens removed using EMR from patients with HGD or IMCA, 20 each from the ”inject, suck, and cut” and the ”band and snare” techniques. Specimens were evaluated and measured separately by two pathologists for greatest diameter and depth, and for the presence of submucosa and muscularis propria at the deepest margin of resection. Follow-up data were collected regarding clinical outcome and stricture formation.

Results: The mean depth of the specimens from the two techniques was not significantly different (0.51 cm vs. 0.50 cm, P = 0.76). All specimens contained substantial submucosa, allowing accurate staging of the neoplastic lesions resected. Muscularis propria was identified at the base of 65 % of the ”band and snare” and 50 % of the ”inject, suck, and cut” specimens (P = 0.52).

Conclusions: The ”inject, suck, and cut” and ”band and snare” techniques both yield equivalent adequate depth of histological specimens from Barrett’s esophagus with HGD or IMCA, and both provide accurate pathological staging.

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C. J. Lightdale, MD 

Columbia University Medical Center

161 Fort Washington Avenue

New York

NY 10032

USA

Email: cjl18@columbia.edu