Successful Treatment of an Early Barrett’s Adenocarcinoma in a High-Risk Patient with Portal Hypertension: The “Band and Leave” Strategy

Author:

Fraile-López Miguel123,Ortiz-Fernández-Sordo Jacobo3,James Martin3,Kaye Philip3,Ragunath Krish3

Affiliation:

1. Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain

2. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Principado de Asturias, Oviedo, Spain

3. NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, United Kingdom

Abstract

Abstract“Band and leave” strategy has been described for the resection of submucosal tumors of the digestive tract to reduce the complications related to deep submucosal resection such as bleeding and perforation. We present the case of a patient with multiple comorbidities, chronic liver disease, and portal hypertension diagnosed to have T1 adenocarcinoma in Barrett's esophagus overlying a column of varix. This was successfully treated by band ligation and allowing the neoplastic mucosa to slough. We propose this technique as an alternative therapeutic option for the management of early Barrett’s neoplasia in such high-risk patients with portal hypertension.

Publisher

Georg Thieme Verlag KG

Subject

Gastroenterology,Radiology Nuclear Medicine and imaging

Reference4 articles.

1. Endoscopic band ligation without resection in selected patients for small and superficial upper gastrointestinal tract lesions;G Ibáñez-Sanz;Rev Esp Enferm Dig,2016

2. Endoscopic band ligation without electrosurgery: a new technique for excision of small upper-GI leiomyoma;S Sun;Gastrointest Endosc,2004

3. Small duodenal carcinoids: a case series comparing endoscopic resection and autoamputation with band ligation;J R Scherer;J Clin Gastroenterol,2015

4. Band ligation of a T1 esophageal squamous cell cancer in a patient with multimorbidities;S Salord;Endoscopy,2012

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