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Efficacy and Safety of Multiband Mucosectomy Versus Cap-assisted Endoscopic Resection For Early Esophageal Cancer and Precancerous Lesions

A Systematic Review and Meta-Analysis

Dan, Xiang MD*; Lv, Xiu-He MD; San, Zhi-Jie MD; Geng, Sang MD*; Wang, Yan-Qiang MD*; Li, Shao-Hua MD; Xie, Hua-Hong MD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: October 2019 - Volume 29 - Issue 5 - p 313–320
doi: 10.1097/SLE.0000000000000711
Review Articles
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Background: The effectiveness of multiband mucosectomy (MBM) for early esophageal cancer and precancerous lesions is still in uncertainty. We aimed to evaluate the efficacy and safety of this procedure and to compare it with cap-assisted endoscopic resection (EMR-cap).

Methods: A systematic search of both English and Chinese databases was performed from inception to April 30, 2019. Complete resection rate, local recurrence rate, and procedure time were considered the primary outcome measures. Prevalence of complications was considered the secondary outcome measure. All data analyses were performed using Review Manager Software.

Results: Two randomized controlled trials (RCTs) and 3 non-RCTs were included in the final meta-analysis. When compared with the EMR-cap technique, MBM had a similar complete resection rate [odds ratio (OR)=2.09, 95% confidence interval (CI): 0.78-5.60, P=0.14], a similar local recurrence rate (OR=0.50, 95% CI: 0.09-2.67, P=0.42), a shorter resection time (mean difference: −9.08, 95% CI: −13.86 to −4.30, P=0.0002), a shorter procedure time (mean difference: −13.36, 95% CI: −17.85 to −8.86, P<0.00001), a lower bleeding rate (OR=0.45, 95% CI: 0.24-0.83, P=0.01), a similar perforation rate (OR=0.55, 95% CI: 0.15-2.06, P=0.37), and a similar stricture rate (OR=0.77, 95% CI: 0.10-5.84, P=0.80). The results of non-RCTs were consistent with those of RCTs.

Conclusions: MBM is similar to EMR-cap in terms of efficacy and safety for endoscopic resection of early cancer and precancerous lesions of the esophagus. However, MBM is less time-consuming.

Departments of *Internal Medicine

General Surgery, People’s Hospital of Hainan Tibetan Autonomous Prefecture, Qinghai Province

Department of Gastroenterology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, Shaanxi Province, People’s Republic of China

X.D. and X.-H.L. contributed equally.

The authors declares no conflicts of interest.

Reprints: Hua-Hong Xie, MD, Department of Gastroenterology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, People’s Republic of China (e-mail: fangfang1@fmmu.edu.cn).

Received July 30, 2018

Accepted June 26, 2019

Online date: August 20, 2019

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