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; CF Consiglieri; C Loras; X Andújar; C Huertas; M Albert; R Ballester; F González-Huix; C Guarner-Argente; A Pardo; J Bosch-Schips; JB Gornals

doi:10.1055/s-0039-1681312

Endoscopy, Table of Contents

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

¹Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge – IDIBELL, Barcelona, Spain

,

CF Consiglieri

¹Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge – IDIBELL, Barcelona, Spain

,

C Loras

²Endoscopy Unit, Digestive Diseases Department, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain

,

X Andújar

²Endoscopy Unit, Digestive Diseases Department, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain

,

C Huertas

³Digestive Diseases Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain

,

M Albert

³Digestive Diseases Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain

,

R Ballester

⁴Endoscopy Unit, Digestive Diseases Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain

,

F González-Huix

⁴Endoscopy Unit, Digestive Diseases Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain

,

C Guarner-Argente

⁵Endoscopy Unit, Digestive Diseases Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

,

A Pardo

⁶Digestive Diseases Department, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain

,

J Bosch-Schips

⁷Pathological Anatomy Department, Hospital Universitari de Bellvitge – IDIBELL, Barcelona, Spain

,

JB Gornals

¹Endoscopy Unit, Digestive Diseases Department, Hospital Universitari de Bellvitge – IDIBELL, Barcelona, Spain

› Author Affiliations

Abstract

Full Text

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.