Multi-band mucosectomy for neoplasia in patients with Barrett's esophagus: in vivo comparison between two different devices

Surg Endosc. 2020 Sep;34(9):3845-3852. doi: 10.1007/s00464-019-07150-w. Epub 2019 Oct 4.

Abstract

Background: Multi-band mucosectomy (MBM) is effective and safe for Barrett's neoplasia. No studies have yet compared the efficacy and safety of the MBM devices commercially available: Duette™ (CookMedical) and Captivator™ (BostonScientific). Our aim is to compare the two devices.

Methods: This is a dual-center retrospective case-control study (Rozzano, Portsmouth) comparing efficacy, safety, and histology of resected specimens between Duette™ (DUE) and Captivator™ (CAPT). Efficacy was assessed by R0 and local recurrence (LR) rate. Bleedings, perforations, and strictures were recorded as safety outcomes. Moreover, the specimens were re-examined by two pathologists, blinded about the study group, to assess the maximum thickness of both the whole specimens and the resected submucosal layer.

Results: Seventy-six patients (38 per group) were included. The two groups did not differ in terms of baseline characteristics. R0 resection was achieved in 96.7% versus 96.3% (p = ns) and LR were recorded in 4/38 (10.5%) versus 3/38 (7.9%) in DUE and CAPT group, respectively (p = ns). Considering Duette™ versus Captivator™, 2 versus 3 patients developed a symptomatic stricture. Only one post-procedural bleeding occurred (Captivator™). Maximum medium thicknesses of specimens and of resected submucosa did not differ between the groups.

Conclusions: MBM is safe and effective for resecting visible lesions using either of the two available devices.

Keywords: Barrett’s esophagus; Endoscopic resection; Endoscopy; Esophagus; Multi-band mucosectomy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Barrett Esophagus / surgery*
  • Case-Control Studies
  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / instrumentation*
  • Esophageal Neoplasms / surgery*
  • Esophagoscopy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neoplasm Recurrence, Local / pathology
  • Retrospective Studies