Year: 2007
Type: dissertation
Abstract: Aim To prospectively evaluate the safety of endoscopic resection for early neoplasia in Barrett’s esophagus using the endoscopic cap resection technique. Patient & methods All resections performed between September 2000 and March 2006 with the ER-cap technique in patients with Barrett’s esophagus were included. Complications were classified “acute” (during the ER procedure) or “early” (< 48 hours after ER). Results 216 ER-cap procedures were performed in 121 patients. 145 ERs were performed with a standard hard cap and 71 with a large flexible cap. Specimens removed with the standard cap had a mean diameter of 20 mm (SD 5.0) vs 23 mm (SD 5.8) for the large cap (p<0.001). Acute complications occurred in 51 procedures (24%): 49 bleedings and 2 perforations. All bleedings were effectively treated with haemostatic techniques and classified as mild complications: none of the patients had a drop in hemoglobin levels, required blood transfusions or repeat interventions. The two perforations were classified as severe complications and were treated conservatively. Three (1%) early complications occurred, all bleedings, effectively treated with endoscopic hemostatic techniques and classified as moderately severe complications. In multivariate analysis the indication for the resection (HGIN or EC vs. LGIN or no dysplasia) was found to be significantly associated with an increased risk of acute bleeding. Conclusions Endoscopic cap resection in Barrett’s esophagus is safe. Most complications become apparent immediately during the procedure and can be managed endoscopically. Bleeding after the ER procedure and severe acute complications (i.e. perforations) are rare (2%).
Author: FP Peters
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: National Cancer Institute
OpenAlex ID: W2126787220