A randomized trial comparing the ER-cap technique and the multiband mucosectomy technique for piecemeal endoscopic resection of early Barrett neoplasia.

This study will be performed at the AMC in Amsterdam, St. Antonius Hospital in Nieuwegein, Catharina Hospital in Eindhoven and the Gasthuisberg in Leuven.



Endoscopic resection (ER) is an important treatment modality for patients with Barrett esophagus (BE) containing high-grade dysplasia (HGD) or early cancer (EC). The most widely used ER technique, the ER-cap technique, requires submucosal lifting and prelooping of a snare in the cap, making it technically demanding and laborious when used for piecemeal resections. In addition, a new snare is needed for every resection.
The newer multi-band mucosectomy (MBM) technique uses a modified variceal band ligator and requires no submucosal lifting or prelooping of a snare, and multiple resections can be performed with the same snare. Aim of this study is to prospectively compare ER-cap and MBM for piecemeal ER in BE.

A total of 80 patients with BE-HGD/EC scheduled for piecemeal ER will be included. After delineation of the area to be resected, patients will be randomized to ER-cap or MBM. Assessment criteria are: number of resections/procedure, procedure time, time/resected specimen, complications, maximum diameter of specimens, and costs of disposables.


We hypothesize that both techniques will be equally effective, but MBM may be quicker, cheaper and may even be associated with less complications.

We hypothesize that endoscopic resection (ER) of early neoplasia arising in Barrett esophagus (BE) using the multiband mucosectomy (MBM) technique is equally effective in removing early neoplasia, but may be faster, cheaper and possibly safer than the standard ER-cap technique.

The patient will be randomized and treated in the same endoscopy session.

Patients are randomized to undergo endoscopic resection using either the standard ER-cap technique, or the newer multiband mucosectomy technique.