Cryotherapy versus radiofrequency ablation in the treatment of dysplastic Barrett's esophagus with or without early esophageal neoplasia: a systematic review and meta-analysis.

IF 2.1 Q3 GASTROENTEROLOGY & HEPATOLOGY

Clinical Endoscopy Pub Date : 2024-03-01 Epub Date: 2024-01-17 DOI:10.5946/ce.2023.065

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

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引用次数: 0

Abstract

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.

Conclusion: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.

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冷冻疗法与射频消融术在治疗伴有或不伴有早期食管肿瘤的发育不良巴雷特食管中的比较：系统综述和荟萃分析。

背景/目的：射频消融（RFA）是治疗发育不良的巴雷特食管（BE）的一线疗法。因此，冷冻疗法已成为一种替代疗法。本研究旨在根据完全消除肠化生（CE-IM）和发育不良（CE-D）的比率，比较这两种技术的疗效。此外，还报告了不良事件和复发情况：方法：使用 Medline (PubMed)、Embase、LILACS 和 Google Scholar 数据库进行电子检索，检索期至 2022 年 12 月。纳入的研究对冷冻疗法和射频消融术治疗伴有或不伴有早期食管肿瘤的发育不良 BE 进行了比较。本研究根据《系统综述和荟萃分析首选报告项目》指南进行：结果：共纳入了三项回顾性队列研究，涉及 627 名患者。其中，399 名患者接受了 RFA 治疗，228 名患者接受了冷冻治疗。两组患者的CE-IM（风险差异[RD]，-0.03；95% 置信区间[CI]，-0.25 至 0.19；P=0.78；I2=86%）和CE-D（风险差异[RD]，-0.03；95% 置信区间[CI]，-0.15 至 0.09；P=0.64；I2=70%）均无差异。不良反应的绝对数量较低，复发率也没有差异：结论：冷冻疗法和射频消融术在治疗有或没有早期食管肿瘤的发育不良BE方面同样有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endoscopy GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.40

自引率

8.00%

发文量

审稿时长

26 weeks