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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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Graphical Abstract
Abstract
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Supplementary Material
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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
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- 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
- Cryotherapy versus radiofrequency ablation in the treatment of post-chemoradiotherapy patients with recurrence of Barrett’s dysplasia
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Original Article
- Assessment on the Potential Role of Applying Cryoprobe for Tissue Ablation
- Min Ho Seo, Yoon Tae Jeen, Sang Jung Park, Sun Young Kim, Hye Jin Cho, Hyuk Sun Choi, Hoon Jai Chun, Chang Duck Kim, Ho Sang Ryu, Yang Seok Chae
- Clin Endosc 2012;45(1):67-72. Published online March 31, 2012
- DOI: https://doi.org/10.5946/ce.2012.45.1.67
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Abstract
PDFPubReaderePub
Background/Aims Cryotherapy is the therapeutic application for tissue ablation. Clinical applications of cryotherpy such as in pulmonology have increased. Until now, its development in gastroenterology has been insignificant. But, as clinical application such as mucosal ablation on Barrett's esophagus became possible, various applications have been developed. Therefore, it is important to make standards of tissue injury's extent in cryotherapy prior to clinical trial. We evaluated the tissue injury according to the application of cryoprobe with a pig model.
Methods Cryoprobe was applied to several different segments of the esophagus and stomach for various lengths of time using various number of probe's contact in a pig model. After 48 hours, esophagus and stomach were harvested and histological tissue injury was assessed. The extent of tissue injury was decided by the injury of the deepest layer.
Results Endoscopic application of cryoprobe on esophagus and stomach resulted in a dose-dependent injury: esophageal necrosis was limited to the submucosa after 10 seconds of cryotherapy, and extended to involve the transmural necrosis after over 15 seconds. Necrosis on stomach was extended to involve the transmural necrosis after over 20 seconds.
Conclusions Positive relationship was seen between the duration and frequency of cryoprobe application and the extent of tissue injury.
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