There are several endoscopic resection techniques for early stage cancer of the upper GI tract. Some are more effective than strip biopsy.
However, there have been no prospective randomized comparisons.
In this study, investigators from Germany evaluated 100 consecutive endoscopic resections in 72 patients with early stage esophageal cancer.
The team performed 50 endoscopic resections using a “suck-and-ligate” device without prior submucosa injection. The remaining 50 were performed using the cap technique with prior submucosa injection of a dilute saline solution of epinephrine.
The team evaluated the maximum diameter of the resection specimen and resection area, as well as the complication rate.
The investigators were unable to identify any significant differences between the 2 groups with regard to the maximum diameters and calculated area of the resected specimens.
They also did not find any differences in the maximum diameters and calculated area of the endoscopic resection ulcers after 24 hours.
|There was a slight advantage for ligation group patients who had prior endoscopic treatment.|
Furthermore, the team found that there was only a slight advantage for ligation group patients who had prior endoscopic treatment.
The team identified 1 minor episode of bleeding in each group, and no severe complications.
In addition, 57% of patients required further endoscopic therapy after resection due to residual neoplasia at the first follow-up endoscopy.
Dr Andrea May's team concluded, "The cap technique with submucosa injection and the ligation technique without submucosa injection are similar with respect to efficacy and safety for endoscopic resection of early stage esophageal cancers".