Kamar Belghazi1, Norman Marcon2, Christopher Teshima2, Kenneth K Wang3, Reza V Milano1, Nahid Mostafavi4, Michael B Wallace5, Pujan Kandel5, Lady Katherine Mejía Pérez5, Michael J Bourke6, Farzan Bahin6, Martin A Everson7, Rehan Haidry7, Gregory G Ginsberg8, Gene K Ma8, Arjun D Koch9, Krish Ragunath10, Jacobo Ortiz-Fernandez-Sordo10, Massimiliano di Pietro11, Stefan Seewald12, Bas L Weusten13, Erik J Schoon14, Raf Bisschops15, Jacques J Bergman1, Roos E Pouw1. 1. Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 2. Department of Gastroenterology, St. Michaels Hospital, Toronto, Ontario, Canada. 3. Department of Gastroenterology, Mayo Clinic Rochester, Rochester, Minnesota, USA. 4. Biostatistical Unit, Department of Gastroenterology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 5. Department of Gastroenterology, Mayo Clinic Florida, Jacksonville, Florida, USA. 6. Department of Gastroenterology, Westmead Hospital, University of Sydney, Sydney, Australia. 7. Department of Gastroenterology, University College Hospital, London, United Kingdom. 8. Gastroenterology Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. 9. Department of Gastroenterology and Hepatology, Erasmus MC, Cancer Institute, Rotterdam, the Netherlands. 10. Nottingham Digestive Diseases Centre & NIHR Biomedical Research Centre, Nottingham University Hospital, Nottingham, United Kingdom. 11. MRC Cancer Unit, University of Cambridge, Cambridge, United Kingdom. 12. Department of Gastroenterology, GastroZentrum Hirslanden Zürich, Switzerland. 13. Department of Gastroenterology and Hepatology, St. Antonius hospital, Nieuwegein, the Netherlands. 14. Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands. 15. Department of Gastroenterology and Hepatology, UZ Leuven, KU Leuven, Belgium.
Abstract
BACKGROUND AND AIMS: Multiband mucosectomy (MBM) is a widely used technique for the treatment of Barrett's esophagus (BE). However, large multicenter studies enabling a generalizable estimation of the risk of serious adverse events, such as perforation and postprocedural bleeding, are lacking. The aim of this study was to estimate the rate of, and risk factors for, serious adverse events associated with MBM. METHODS: In this retrospective analysis, consecutive patients who underwent MBM for treatment of BE in 14 tertiary referral centers in Europe, the United States, Canada, and Australia were included. Primary outcomes were perforation and postprocedural bleeding rate. Potential risk factors were identified by logistic regression. RESULTS: Between 2001 and 2016, a total of 3827 MBM procedures were performed in 2447 patients (84% male, mean age 66 years, median BE length C2M4). Perforation occurred in 17 procedures (0.4%; 95% confidence interval [CI], 0.3-0.7), of which 15 could be treated endoscopically or conservatively. Female gender was an independent risk factor for perforation (odds ratio [OR], 2.77; 95% CI, 1.02-7.57; P = .05). Postprocedural bleeding occurred after 35 procedures (0.9%; 95% CI, 0.6-1.3). The number of resections (OR, 1.15; 95% CI, 1.06-1.25; P < .001) was significantly associated with postprocedural bleeding. CONCLUSION: The results of this study show that MBM for BE is safe with a low risk of serious adverse events. In addition, most of the adverse events could be managed endoscopically or conservatively. The number of resections was an independent risk factor for postprocedural bleeding.
BACKGROUND AND AIMS: Multiband mucosectomy (MBM) is a widely used technique for the treatment of Barrett's esophagus (BE). However, large multicenter studies enabling a generalizable estimation of the risk of serious adverse events, such as perforation and postprocedural bleeding, are lacking. The aim of this study was to estimate the rate of, and risk factors for, serious adverse events associated with MBM. METHODS: In this retrospective analysis, consecutive patients who underwent MBM for treatment of BE in 14 tertiary referral centers in Europe, the United States, Canada, and Australia were included. Primary outcomes were perforation and postprocedural bleeding rate. Potential risk factors were identified by logistic regression. RESULTS: Between 2001 and 2016, a total of 3827 MBM procedures were performed in 2447 patients (84% male, mean age 66 years, median BE length C2M4). Perforation occurred in 17 procedures (0.4%; 95% confidence interval [CI], 0.3-0.7), of which 15 could be treated endoscopically or conservatively. Female gender was an independent risk factor for perforation (odds ratio [OR], 2.77; 95% CI, 1.02-7.57; P = .05). Postprocedural bleeding occurred after 35 procedures (0.9%; 95% CI, 0.6-1.3). The number of resections (OR, 1.15; 95% CI, 1.06-1.25; P < .001) was significantly associated with postprocedural bleeding. CONCLUSION: The results of this study show that MBM for BE is safe with a low risk of serious adverse events. In addition, most of the adverse events could be managed endoscopically or conservatively. The number of resections was an independent risk factor for postprocedural bleeding.
Authors: S N van Munster; E A Nieuwenhuis; B L A M Weusten; L Alvarez Herrero; A Bogte; A Alkhalaf; B E Schenk; E J Schoon; W Curvers; A D Koch; S E M van de Ven; P J F de Jonge; T Tang; W B Nagengast; F T M Peters; J Westerhof; M H M G Houben; Jacques J G H M Bergman; R E Pouw Journal: J Gastrointest Surg Date: 2020-11-02 Impact factor: 3.452
Authors: Sanne van Munster; Esther Nieuwenhuis; Bas L A M Weusten; Lorenza Alvarez Herrero; Auke Bogte; Alaa Alkhalaf; B E Schenk; Erik J Schoon; Wouter Curvers; Arjun D Koch; Steffi Elisabeth Maria van de Ven; Pieter Jan Floris de Jonge; Tjon J Tang; Wouter B Nagengast; Frans T M Peters; Jessie Westerhof; Martin H M G Houben; Jacques Jghm Bergman; Roos E Pouw Journal: Gut Date: 2021-03-22 Impact factor: 23.059