The Daignosis And Treatment Of Endoscopic Banding Ligation Of Gastrointestinal Submucosal Lesions

Objective:Endoscopic band ligation for variceal bleeding in cirrhosis has been proved its safety and efficacy. It has been used into gastrointestinal disease widely.We tried to treat submucosal lesions of gastrointestinal (GI) tract by endoscopic band ligation. The aim of this study was to evaluate the efficacy and safety of endoscopic band ligation in the treatment of submucosal lesions of the GI tract.METHODS:A retrospective study was performed among131patiens who has153submucosal lesions of the GI tract.They were undergoing the Endoscopic band ligation in the Endoscopy Center at the First Affiliated Hospital of Zhejiang University from May2012to December2014. Among the submucosal lesions,by the daignosis of EUS,60cases located in superficial layer,67cases located in deep layer. And40lesions were in the esophagus,102lesions were in the of stomach and9lesion were in the duodenal bulb,2lesions were in colon.Among153submucosal lesions,67lesions from the muscularis propria,47patiens was collected who has47submucosal lesions within the same period.The lesions from the muscularis propria were diagnosed by the EUS,eventually pathological diagnosis were mesenchymoma. RESULTS:All submucosal lesions were successfully removed by band ligation.No perforation in all patients,but there are2patients had bleeding,the leeding rate was1.5%(2/131).94patient was following up, the follow-up rate was71.7%(94/131).In the following-up,2patients has found the lesion left,the tumor elimination rate was97.8%(92/94), tumor residual rate was2.1%(2/94). No perforation and bleeding was observed for the following-up.The risk of bleeding of endoscopic band ligation has correlation with lesion long diameter (p=0.00) and short diameter (p=0.00).The efficacy has correlation with lesion long diameter(p=0.05), irrelevant with short diameter(p=0.364).The patient who undergone ESD had more serious clinical symptoms,all the lesions located in the stomach,long diameter and short diameter of lesions was longer than EBL.The bleeding rate of ESD was38.3%,perforation rate was23.4%.The bleeding rate of EBL was2.9%,perforation rate was0%,both had significantly correlation.CONCLUSION:Endoscopic band ligation could be considered as a safe, cheap, easy-learning therapy for the treatment of the submucosal lesion of the GI tract. For the lesion from muscularis propria, lesion long diameter was<1.5cm,shorter diameter was<1.0cm submucosal lesions, endoscopic band ligation was a safe, low risk of bleeding and perforation treatment.Endoscopic ultrasonography assess the size and source of lesions,which was significant to the endoscopic band ligation.