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Open Access 01-11-2019 | Barrett Esophagus

Comparison of two multiband mucosectomy devices for endoscopic resection of Barrett’s esophagus-related neoplasia

Authors: Durayd Alzoubaidi, David Graham, Paul Bassett, Cormac Magee, Martin Everson, Matthew Banks, Marco Novelli, Marnix Jansen, Laurence B. Lovat, Rehan Haidry

Published in: Surgical Endoscopy | Issue 11/2019

Abstract

Background

Esophageal adenocarcinoma carries a poor prognosis and therefore treatment of early neoplasia arising in the precursor condition Barrett’s esophagus (BE) is desirable. Visible lesions arising in BE need endoscopic mucosal resection for accurate staging and removal. Resection modalities include a cap-based system with snare and custom-made multiband mucosectomy (MBM) devices (Duette, Cook Medical Ltd). A new MBM device has recently become available (Captivator, Boston Scientific Ltd).

Objectives

A retrospective pilot study to compare the efficacy, safety, specimen size and histology of endoscopic mucosal resection (EMR) specimens resected with two MBM devices (Cook Duette and Boston Captivator) in treatment naive patients undergoing endoscopic therapy for BE neoplasia.

Methods

Consecutive EMR procedures carried out by a single experienced endoscopist were analysed. All visible lesions were marked and resected using one of the two MBM devices. All resected specimens were analysed by the same two experienced pathologists. The resected specimens in both groups were analysed for maximum diameter, minimum diameter, surface area and depth.

Results

Twenty consecutive patients were analysed (18M + 2F; mean age 74) in the Duette group and 20 (17M + 3F; mean age 72) in the Captivator group. A total of 58 specimens were resected in the Duette and 63 in the Captivator group. Min diameter, max diameter, surface area and depth of the ER specimens resected by the Captivator device were significantly larger than that by the Duette device [min diameter 9.89 mm vs 9.07 mm (p = 0.019); max diameter: 13.54 mm vs 12.38 mm (p = 0.024); surface area: 135.40 mm² vs 113.89 mm² (p = 0.005); depth 3.71 mm vs 2.89 (p = 0.001)].

Conclusions

These two MBM devices showed equivalent efficacy and safety outcomes, but the EMR Captivator device resected specimens with a larger area in the esophagus when compared with the Duette device. A possible advantage of this is in situations where en bloc resections with fewer EMRs are desirable for larger lesions.

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Title: Comparison of two multiband mucosectomy devices for endoscopic resection of Barrett’s esophagus-related neoplasia
Authors: Durayd Alzoubaidi
David Graham
Paul Bassett
Cormac Magee
Martin Everson
Matthew Banks
Marco Novelli
Marnix Jansen
Laurence B. Lovat
Rehan Haidry
Publication date: 01-11-2019
Publisher: Springer US
Keyword: Barrett Esophagus
Published in: Surgical Endoscopy / Issue 11/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-06655-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of two multiband mucosectomy devices for endoscopic resection of Barrett’s esophagus-related neoplasia

Abstract

Background

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusions

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