title: Endoscopic mucosal resection for proximal superficial lesions: efficacy and safety study in 59 consecutive resections.
abstract: BACKGROUND
  endoscopic mucosal resection is an accepted technique for the treatment of proximal gastrointestinal tract superficial lesions.
  
  
  OBJECTIVE
  to evaluate the efficacy and safety of this procedure in the proximal gastrointestinal tract.
  
  
  METHODS
  forty one consecutive patients (23 males and 18 females, mean age of 61 ± 11.5 years) were included in our study. Fifty nine resections were performed in these patients in 69 sessions. Lesions treated consisted of elevated lesions with high grade dysplasia in the context of Barrett's esophagus (group A), high grade dysplasia appearing in random biopsies taken during the follow-up of Barrett's esophagus (group B) and superficial gastroduodenal lesions (group C). Snare resection after submucosal injection, band ligator-assisted or cap-assisted mucosal resection were the chosen techniques.
  
  
  RESULTS
  we resected 7 elevated lesions with high grade dysplasia in the context of Barrett's esophagus, 6 complete Barrett's esophagus with high grade dysplasia in 16 sequential sessions and 46 gastroduodenal superficial lesions (10 adenomas, 9 gastric superficial carcinomas, 18 carcinoid tumours and 9 lesions of different histological nature). Resections in the two first groups were complete in 100% of the cases, and in 97.9% of the cases in group C. Complications included 2 cases of limited deferred bleeding (groups A and B) and another two cases of stenosis with little clinical relevance in Group B.
  
  
  CONCLUSIONS
  a) endoscopic mucosal resection is an efficient technique for the treatment of proximal gastrointestinal tract superficial lesions; b) it is a safe procedure with a low percentage of complications, which can generally be managed endoscopically; and c) in contrast with other ablative techniques, endoscopic mucosal resection offers the possibility of a pathologic analysis of the samples.
authors.affiliation: Department of Gastroenterology and Hepatology, Complejo Hospitalario de Navarra, Pamplona, Spain. edualbeniz@hotmail.com
authors.forename: Eduardo
authors.initials: E
authors.lastname: Albéniz-Arbizu
authors.forename: Antonio
authors.initials: A
authors.lastname: Pueyo-Royo
authors.forename: Javier
authors.initials: J
authors.lastname: Eguaras-Ros
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: Casi-Villarroya
authors.forename: David
authors.initials: D
authors.lastname: Ruiz-Clavijo-García
authors.forename: Susana
authors.initials: S
authors.lastname: Oquiñena-Legaz
authors.forename: Rosa
authors.initials: R
authors.lastname: Iglesias-Picazo
authors.forename: Rosario
authors.initials: R
authors.lastname: Aznárez-Barrio
authors.forename: Helena
authors.initials: H
authors.lastname: León-Brito
authors.forename: Carlos
authors.initials: C
authors.lastname: Jiménez-López
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D004378:Duodenal Diseases / Q000473:pathology / Q000601:surgery*; D004384:Duodenoscopy / Q000009:adverse effects; D004564:Electrocoagulation / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013272:Stomach Diseases / Q000473:pathology / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery