title: Endoscopic band ligation without resection in selected patients for small and superficial upper gastrointestinal tract lesions.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of endoscopic band ligation (EBL) in carefully selected patients who would benefit from this method of resection.
  
  
  METHODS
  Patients with early upper gastrointestinal and small (< 15 mm) lesions treated with EBL (Duette® Multi-Band Mucosectomy) were prospectively recruited and retrospectively analyzed between 2010 and 2015. All cases were discussed in a multidisciplinary cancer committee and it was concluded that, owing to patient conditions, surgery was not possible and that not conducting histology would not change the clinical management. A first endoscopic control with biopsies was planned at 4-8 weeks. If there was no persistence of the lesion, new controls were programmed at 6 and 12 months.
  
  
  RESULTS
  The group (n = 12) included 5 esophagus lesions (adenosquamous carcinoma, n = 1; carcinoma squamous, n = 2; adenocarcinoma, n = 2); 4 gastric lesions (high grade dysplasia, n = 1; adenocarcinoma, n = 2; neuroendocrine tumor [NET], n = 1), and 3 duodenal lesions (NETs) (n = 3). The mean tumor diameter was 9.6 ± 2.8 mm (range 4-15). Only one minor adverse event was described. At first follow-up (4-8 weeks), there was 91.6% and 75% of endoscopic and histological remission, respectively. At 6-month follow-up there was 70% of both endoscopic remission and negative biopsies. And at 12 months, there was 100% and 75% of endoscopic and histological remission, respectively. Persisting lesions were T1 cancers. The median follow-up was 30.6 months.
  
  
  CONCLUSIONS
  EBL without resection is an easy and safe technique that should be considered in patients with multiple morbidities and small superficial UGI lesions.
authors.affiliation: Gastroenterología, Hospital Universitari de Bellvitge-IDIBELL, España.
authors.forename: Gemma
authors.initials: G
authors.lastname: Ibáñez-Sanz
authors.affiliation: Endoscopia/Aparato Digestivo, Hospital Universitari de Bellvitge, España.
authors.forename: Joan B
authors.initials: JB
authors.lastname: Gornals
authors.affiliation: Hospital Universitari de Bellvitge-IDIBELL.
authors.forename: Laura
authors.initials: L
authors.lastname: Rivas
authors.affiliation: Hospital Universitari de Bellvitge-IDIBELL.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Salord
authors.affiliation: Hospital Universitari de Bellvitge-IDIBELL.
authors.forename: María José
authors.initials: MJ
authors.lastname: Paúles
authors.affiliation: Hospital Universitari de Bellvitge-IDIBELL.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Botargues
authors.affiliation: Institut Català d'Oncologia DiR-IDIBELL.
authors.forename: Maica
authors.initials: M
authors.lastname: Galán
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000601:surgery; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D041742:Upper Gastrointestinal Tract / Q000601:surgery*