Clinical Endoscopy

Systematic Review and Meta-analysis

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

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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

Cryotherapy versus radiofrequency ablation in the treatment of post-chemoradiotherapy patients with recurrence of Barrett’s dysplasia
Shiraz Mohammed Khan, Sirsha Kundu, Jade Godfrey, Claudio Buggiotti, Hasan Haboubi
Clinical Endoscopy.2025; 58(1): 161. CrossRef
High Quality Barrett’s Esophagus Examination and Endoscopic Eradication Therapy
Shirin Dey, Kevin Shah, Srinadh Komanduri
Gastrointestinal Endoscopy Clinics of North America.2025; 35(3): 523. CrossRef
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

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Systematic Review and Meta-Analysis

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

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Ali A Alali, Alan N Barkun
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6,440 View
268 Download
12 Web of Science
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