AI Article Synopsis

  • Multiband mucosectomy (MBM) is a popular treatment for Barrett's esophagus but lacks large-scale studies on serious risks like perforation and bleeding.
  • A study analyzed MBM procedures across 14 centers from 2001 to 2016, involving 3,827 procedures and identifying the rates of perforation (0.4%) and postprocedural bleeding (0.9%).
  • Female gender was a risk factor for perforation, and a higher number of resections increased the risk of postprocedural bleeding, indicating MBM is generally safe with manageable adverse events.

Article 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.

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Source
http://dx.doi.org/10.1016/j.gie.2020.03.3842DOI Listing

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