title: [Prevention and treatment of complications during and after endoscopic mucosal band ligation for esophageal precancerous lesions and early cancer].
abstract: OBJECTIVE
  To investigate the prevention and treatment of complications during and after endoscopic mucosal band ligation (EMBL) for precancerous lesions and early cancer in the esophagus.
  
  
  METHODS
  Clinical data of 47 patients with esophageal precancerous lesions and early cancer undergoing EMBL in our center from June 2011 to August 2013 were reviewed retrospectively. Complications and associated treatment during operation, after operation and during follow-up were analyzed.
  
  
  RESULTS
  Complications during operation included 7 cases of bleeding (14.9%) and 1 case of perforation (2.1%), who received hot biopsy forceps and argon plasma coagulation to stop bleeding successfully, and titanium clamp to suture wound surface. No cutaneous emphysema and pneumothorax occurred. Complications after operation included 1 case of delayed bleeding (2.1%) who received blood stopping under gastroscope, 2 cases of mediastinal and subcutaneous emphysema (4.3%), 6 cases of pleural effusion (12.8%), and 5 cases of minor inflammation or segmental atelectasis of pulmonary (10.6%), who all received successful conservative treatment. Seven cases of esophageal stricture occurred during follow-up, who were improved by balloon dilatation and metal-film stent placement. No deaths associated with EMBL occurred. All the complications were cured through conservative treatment. No additional surgery associated with the complications was needed. Post-operative pathology revealed 1 case was chronic inflammatory hyperplasia, 11 were low-grade intraepithelial tumor, 15 were high-grade intraepithelial tumor, 8 were carcinoma in situ, 12 were squamous cancer (8 with invasion into mucous muscular layer, 4 into submucous layer). Only 1 case of submucous cancer needed transthorax esophageal cancer radical operation because of dangerous margin. No relapse case was found during followed-up.
  
  
  CONCLUSIONS
  EMBL can treat the esophageal precancerous lesions and early esophageal cancer effectively and its complications can be managed with conservative therapy usually.
authors.affiliation: Endoscopic Center and Endocopic Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China. renzhong733@gmail.com.
authors.forename: Shu-qing
authors.initials: SQ
authors.lastname: Liu
authors.forename: Zhong
authors.initials: Z
authors.lastname: Ren
authors.forename: Yun-shi
authors.initials: YS
authors.lastname: Zhong
authors.forename: Ping-hong
authors.initials: PH
authors.lastname: Zhou
authors.forename: Qiang
authors.initials: Q
authors.lastname: Shi
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.forename: Jia-min
authors.initials: JM
authors.lastname: Zhou
authors.forename: Li-qing
authors.initials: LQ
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011230:Precancerous Conditions / Q000601:surgery*; D012189:Retrospective Studies