Clinical Endoscopy

Wanderley Marques Bernardo

3 Articles

Cryotherapy versus radiofrequency ablation in the treatment of dysplastic Barrett’s esophagus with or without early esophageal neoplasia: a systematic review and meta-analysis: Igor Logetto Caetité Gomes, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Sérgio Barbosa Marques, Alexandre de Sousa Carlos, Beanie Conceição Medeiros Nunes, Bruno Salomão Hirsch, Guilherme Henrique Peixoto de Oliveira, Roberto Paolo Trasolini, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura; Clin Endosc 2024;57(2):181-190. Published online January 17, 2024; DOI: https://doi.org/10.5946/ce.2023.065

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Radiofrequency ablation (RFA) is the first-line therapy for dysplastic Barrett’s esophagus (BE). Therefore, cryotherapy has emerged as an alternative treatment option. This study aimed to compare the efficacies of these two techniques based on the rates of complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). Adverse events and recurrence have also been reported.
Methods
An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results
Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], –0.03; 95% confidence interval [CI], –0.25 to 0.19; p=0.78; I2=86%) as well as in CE-D (RD, –0.03; 95% CI, –0.15 to 0.09; p=0.64; I2=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate.
Conclusions
Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.

Citations

Citations to this article as recorded by

Efficacy and Safety of Cryoablation in Barrett’s Esophagus and Comparison with Radiofrequency Ablation: A Meta-Analysis
Apostolis Papaefthymiou, Benjamin Norton, Andrea Telese, Daryl Ramai, Alberto Murino, Paraskevas Gkolfakis, John Vargo, Rehan J. Haidry
Cancers.2024; 16(17): 2937. CrossRef

3,848 View
230 Download
1 Web of Science
1 Crossref

Stent versus Balloon Dilation for the Treatment of Dominant Strictures in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis: Marina Tucci Gammaro Baldavira Ferreira, Igor Braga Ribeiro, Diogo Turiani Hourneaux de Moura, Thomas R. McCarty, Alberto Machado da Ponte Neto, Galileu Ferreira Ayala Farias, Antônio Afonso de Miranda Neto, Pedro Victor Aniz Gomes de Oliveira, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura; Clin Endosc 2021;54(6):833-842. Published online July 1, 2021; DOI: https://doi.org/10.5946/ce.2021.052

Abstract PDF PubReader ePub

Background
/Aims: The endoscopic management of primary sclerosing cholangitis (PSC)-associated dominant strictures remains challenging. This systematic review and meta-analysis aimed to compare balloon dilation and stent placement in the treatment of dominant strictures among PSC patients.
Methods
Literature searches on MEDLINE, EMBASE, Cochrane CENTRAL and Lilacs/Bireme were performed for studies published until December 2020. Measured outcomes included clinical efficacy, stricture recurrence, cumulative recurrencefree rate, transplant rate, 5-year survival rate, and adverse events (i.e., pancreatitis, cholangitis, bleeding, perforation and death).
Results
A total of 5 studies (n=467) were included. Based on pooled analyses, there were no differences in clinical efficacy (risk difference [RD], -0.13; 95% confidence interval [CI], -0.58 to 0.33; I²=93%) or transplant rates (RD, -0.09; 95% CI, -0.19 to 0.01; I²=0%); however, the risk of occurrence of adverse events was lower with balloon dilatation than with stent placement (RD,-0.34; 95% CI, -0.45 to -0.23; I²=61%). Among the types of adverse events reported, only the rates of cholangitis/bacteremia were significantly lower in balloon dilation patients (RD, -0.19; 95% CI, -0.25 to -0.13; I²=51%).
Conclusions
Compared to balloon dilation, stent placement for dominant strictures in PSC appeared to have higher complication rates without significant differences in efficacy.

Citations

Citations to this article as recorded by

Treatment of Non-Anastomotic Biliary Strictures after Liver Transplantation: How Effective Is Our Current Treatment Strategy?
Florian A. Michael, Mireen Friedrich-Rust, Hans-Peter Erasmus, Christiana Graf, Olivier Ballo, Mate Knabe, Dirk Walter, Christoph D. Steup, Marcus M. Mücke, Victoria T. Mücke, Kai H. Peiffer, Esra Görgülü, Antonia Mondorf, Wolf O. Bechstein, Natalie Filma
Journal of Clinical Medicine.2023; 12(10): 3491. CrossRef
Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Intestinal Research.2023; 21(4): 420. CrossRef
Liver Transplantation for Primary Sclerosing Cholangitis (PSC) With or Without Inflammatory Bowel Disease (IBD)—A European Society of Organ Transplantation (ESOT) Consensus Statement
M. Carbone, A. Della Penna, C. Mazzarelli, E. De Martin, C. Villard, A. Bergquist, P. D. Line, J. M. Neuberger, S. Al-Shakhshir, P. J. Trivedi, U. Baumann, L. Cristoferi, J. Hov, B. Fischler, N. H. Hadzic, D. Debray, L. D’Antiga, N. Selzner, L. S. Belli,
Transplant International.2023;[Epub] CrossRef
Primary Biliary Cholangitis and Primary Sclerosing Cholangitis: Current Knowledge of Pathogenesis and Therapeutics
Ji-Won Park, Jung-Hee Kim, Sung-Eun Kim, Jang Han Jung, Myoung-Kuk Jang, Sang-Hoon Park, Myung-Seok Lee, Hyoung-Su Kim, Ki Tae Suk, Dong Joon Kim
Biomedicines.2022; 10(6): 1288. CrossRef
Use a biodegradable stent in ERCP and it will never be forgotten
Jesús García-Cano, Eva de la Santa Belda, Francisco Domper
Revista Española de Enfermedades Digestivas.2022;[Epub] CrossRef
Endoscopic stenting of dominant strictures in patients with primary sclerosing cholangitis: When, how, and for how long?
Il Sang Shin, Jong Ho Moon
Endoscopy International Open.2022; 10(09): E1169. CrossRef

4,676 View
138 Download
8 Web of Science
6 Crossref

Endoscopic Band Ligation Versus Argon Plasma Coagulation in the Treatment of Gastric Antral Vascular Ectasia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Bruno Salomão Hirsch, Igor Braga Ribeiro, Mateus Pereira Funari, Diogo Turiani Hourneaux de Moura, Sergio Eiji Matuguma, Sergio A. Sánchez-Luna, Fabio Catache Mancini, Guilherme Henrique Peixoto de Oliveira, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura; Clin Endosc 2021;54(5):669-677. Published online May 31, 2021; DOI: https://doi.org/10.5946/ce.2021.063

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Argon plasma coagulation (APC) is the most commonly used endoscopic treatment for gastric antral vascular ectasia (GAVE). Endoscopic band ligation (EBL) has emerged as an alternative therapy. Our goal was to evaluate the feasibility, efficacy, and safety of APC and EBL for the treatment of GAVE. This is the first systematic review that included only randomized controlled trials (RCTs) on this topic.
Methods
A comprehensive search was performed using electronic databases to identify RCTs comparing APC and EBL for the treatment of GAVE following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
Results
Four RCTs were included, with a total of 204 patients. EBL was related to higher endoscopic eradication rates risk difference [RD], 0.29; 95% confidence interval [CI] [0.14, 0.44]; I²=0%) and less bleeding recurrence than APC (RD, 0.29; 95% CI [0.15, 0.44]; I²=0%). Patients treated with EBL required fewer blood transfusions (mean difference [MD], 1.49; 95% CI [0.28, 2.71]; I²=96%) and hospitalizations (MD, 0.29; 95% CI [0.19, 0.39]; I²=0%). The number of sessions required for the obliteration of lesions was higher with APC. There was no difference in the incidence of adverse events.
Conclusions
EBL is superior to APC in the treatment of GAVE in terms of endoscopic eradication rates, recurrence of bleeding, and transfusion requirements.

Citations

Citations to this article as recorded by

Role of Endoscopy in the Diagnosis, Grading, and Treatment of Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia
Ali Khalifa, Don C. Rockey
Gastrointestinal Endoscopy Clinics of North America.2024; 34(2): 263. CrossRef
Review article: Upper gastrointestinal bleeding – review of current evidence and implications for management
Dennis L. Shung, Loren Laine
Alimentary Pharmacology & Therapeutics.2024; 59(9): 1062. CrossRef
Bevacizumab in combination with octreotide rescues a patient with liver cirrhosis, GAVE syndrome and refractory hemorrhage – a case report
Simon Johannes Gairing, Eva Maria Schleicher, Lukas Müller, Christian Labenz, Felix Darstein, Daniel Grimm, Visvakanth Sivanathan, Arndt Weinmann, Marcus-Alexander Wörns, Roman Kloeckner, Michael B. Pitton, Florian Thieringer, Khan Fareed Rahman, Peter Ro
Zeitschrift für Gastroenterologie.2023; 61(03): 275. CrossRef
A Practical Approach to the Management of Gastric Antral Vascular Ectasia
Matthew H. Meyers, Laura Rodriguez, Michael S. Kriss
American Journal of Gastroenterology.2023; 118(9): 1532. CrossRef
Endoscopic Advances in Hepatology
Emma Vanderschueren, Jonel Trebicka, Wim Laleman
Seminars in Liver Disease.2023; 43(02): 176. CrossRef
Comparisons Between Endoscopic Band Ligation, Radiofrequency Ablation and Endoscopic Thermal Therapy for Gastric Antral Vascular Ectasia: A Meta-Analysis
Cheng-Che Che, Sz-Iuan Shiu, Chung-Wang Ko, Yu-Kang Tu, Chung-Hsin Chang
Digestive Diseases and Sciences.2023; 68(9): 3534. CrossRef
An update on the management of non-variceal upper gastrointestinal bleeding
Ali A Alali, Alan N Barkun
Gastroenterology Report.2022;[Epub] CrossRef
Endoscopic band ligation in the treatment of gastric antral vascular ectasia: a systematic review and meta-analysis
Babu P. Mohan, Gregory Toy, Lena L. Kassab, Suresh Ponnada, Saurabh Chandan, Sheeva Parbhu, Shaun Chandna, Douglas G. Adler
Gastrointestinal Endoscopy.2021; 94(6): 1021. CrossRef

5,148 View
248 Download
7 Web of Science
8 Crossref

Author index