Banding without resection (endoscopic mucosal ligation) as a novel approach for the ablation of short-segment Barrett's epithelium: results of a pilot study.
OBJECTIVE
During an endoscopic variceal ligation, we banded a varix with an overlying tongue of Barrett's epithelium (BE). One month later, the tongue was no longer visible, suggesting that banding could be used to eradicate BE.


OBJECTIVE
To assess the safety and efficacy of banding without resection (BWR) using a variceal banding device for eradicating BE.


METHODS
From April 2004 through September 2005, 30 patients with BE were treated with BWR plus omeprazole 20 mg t.i.d. BWR was repeated monthly until two consecutive endoscopic and histological examinations showed no BE. Thirty Barrett's patients treated with omeprazole 20 mg t.i.d. alone served as a control group.


RESULTS
The BWR treatment group comprised 29 patients with short-segment BE (SSBE) and one with long-segment disease, whereas all 30 of the control patients had SSBE. During a median follow-up of 16.9 months (range 10-24 months), complete eradication of BE was achieved in 29 of 30 patients (97%) in the BWR group. In contrast, BE persisted in all 30 control patients during the same period (P < 0.0005). The mean total number of bands applied per patient was 6.1 (range 1-14) and the mean number of sessions for complete eradication was 3.1 (range 1-7). Adverse events included only mild chest pain and dysphagia that resolved within days.


CONCLUSIONS
BWR appears to be a safe, effective, simple, and widely available technique for eradicating SSBE. This is a pilot study and we do not recommend the ablation of nondysplastic BE at this time. Further studies are needed.
Diaz-Cervantes
Edgardo
E
Saint Joseph's Hospital, Gastroenterology, Endoscopy and Motility Unit, Zacatecas, México.
De-la-Torre-Bravo
Antonio
A
Spechler
Stuart Jon
SJ
Torres-Durazo
Ernesto
E
Sobrino-Cossio
Sergio
S
Martínez-Carrillo
Olimpia
O
Gamboa-Robles
Javier
J
D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001471:Barrett Esophagus / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods*; D009853:Omeprazole / Q000627:therapeutic use; D010865:Pilot Projects; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D009853:Omeprazole