Published online Apr 16, 2015. doi: 10.4253/wjge.v7.i4.370
Peer-review started: August 8, 2014
First decision: November 28, 2014
Revised: December 20, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: April 16, 2015
Processing time: 254 Days and 8.8 Hours
Endoscopic resection (ER) is at present an accepted treatment for superficial gastrointestinal neoplasia. ER provides similar efficacy to surgery; however, it is minimally invasive and less expensive. Endoscopic mucosal resection (EMR) is superior to biopsy for diagnosing advanced dysplasia and can change the diagnostic grade and the management. Several EMR techniques have been described that are alternatively used dependent upon the endoscopist personal experience, the anatomic conditions and the endoscopic appearance of the lesion to be resected. The literature suggests that EMR offers comparable outcomes to surgery for selected indications. EMR techniques using a cap fitted endoscope and EMR using a ligation device [multiband mucosectomy (MBM)] are the most frequently use. MBM technique does not require submucosal injection as with the endoscopic resection-cap technique, multiple resections can be performed with the same snare, pre-looping the endoscopic resection-snare in the ridge of the cap is not necessary, MBM does not require withdrawal of the endoscope between resections and up to six consecutive resections can be performed. This reduces the time and cost required for the procedure, while also reducing patient discomfort. Despite the increasing popularity of MBM, data on the safety and efficacy of this technique in upper gastrointestinal lesions with advanced dysplasia, defined as those lesions that have high-grade dysplasia or early cancer, is limited.
Core tip: Early detection of upper gastrointestinal lesions with advanced dysplasia is especially important in the management of the patients. These changes may indicate an increased risk of cancer or may detect cancer at an earlier stage, when it can be more effectively treated. Multiband mucosectomy (MBM) is an easy endoscopic mucosal resection technique allowing a definitive histologic diagnosis and potentially being curative. The available evidence suggests that MBM for these conditions, has an initial success rate comparable to surgical treatment, but with fewer complications.