Risk factors for serious adverse events associated with multiband mucosectomy in Barrett's esophagus: an international multicenter analysis of 3827 endoscopic resection procedures

Kamar Belghazi, Norman Marcon, Christopher Teshima, Kenneth K Wang, Reza V Milano, Nahid Mostafavi, Michael B Wallace, Pujan Kandel, Lady Katherine Mejía Pérez, Michael J Bourke, Farzan Bahin, Martin A Everson, Rehan Haidry, Gregory G Ginsberg, GeneK Ma, Arjun D Koch, Krish Ragunath, Jacobo Ortiz-Fernandez-Sordo, Massimiliano di Pietro, Stefan SeewaldBas L Weusten, Erik J Schoon, Raf Bisschops, Jacques J Bergman, Roos E Pouw

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Abstract

BACKGROUND AND AIMS: Multiband mucosectomy (MBM) is a widely used technique for the treatment of Barrett's esophagus (BE). However, large multicenter studies enabling a generalizable estimation of the risk of serious adverse events, such as perforation and postprocedural bleeding, are lacking. The aim of this study was to estimate the rate of, and risk factors for, serious adverse events associated with MBM METHODS: In this retrospective analysis consecutive patients who underwent MBM for treatment of BE in 14 tertiary referral centers in Europe, the United States, Canada, and Australia were included. Primary outcomes were perforation and postprocedural bleeding rate. Potential risk factors were identified by logistic regression.

RESULTS: Between 2001 and 2016, a total of 3,827 MBM procedures were performed in 2,447 patients (84% male, mean age 66 years, median BE length C2M4). Perforation occurred in 17 procedures (0.4%; 95% CI, 0.3-0.7), of which 15 could be treated endoscopically or conservatively. Female gender was an independent risk factor for perforation (OR, 2.77; 95% CI,1.02-7.57; p=0.05). Postprocedural bleeding occurred after 35 procedures (0.9%; 95% CI, 0.6-1.3). The number of resections (OR, 1.15; 95% CI, 1.06-1.25; p<0.001) was significantly associated with postprocedural bleeding.

CONCLUSION: The results of this study show that MBM for BE is safe with a low risk of serious adverse events. In addition, the vast majority of adverse events could be managed endoscopically or conservatively. The number of resections was an independent risk factor for postprocedural bleeding.

Original languageEnglish
JournalGastrointestinal Endoscopy
DOIs
Publication statusE-pub ahead of print - 30 Mar 2020

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