Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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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 Caetite Gomes (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Diogo Turiani Hourneaux de Moura (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Igor Braga Ribeiro (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Sergio Barbosa Marques (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Alexandre de Sousa Carlos (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Beanie Conceicao Medeiros Nunes (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Bruno Salomao Hirsch (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Guilherme Henrique Peixoto de Oliveira (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Roberto Paolo Trasolini (Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School) ;
  • Wanderley Marques Bernardo (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine) ;
  • Eduardo Guimaraes Hourneaux de Moura (Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo School of Medicine)
  • Received : 2023.02.27
  • Accepted : 2023.08.26
  • Published : 2024.03.30
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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. Conclusions: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.

Keywords

References

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