Safety and effectiveness of balloon cryoablation for treatment of Barrett’s associated neoplasia: systematic review and meta-analysis
| Autor: | Debdeep Banerjee, Peter V. Draganov, Dennis Yang, Khaai Nguyen, Chelsea Jacobs, Nikhil Kadle, Donevan Westerveld |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Original article business.industry medicine.medical_treatment Perforation (oil well) Intestinal metaplasia Cryoablation medicine.disease Newcastle–Ottawa scale 03 medical and health sciences Editorial 0302 clinical medicine medicine.anatomical_structure Dysplasia 030220 oncology & carcinogenesis Internal medicine Meta-analysis medicine 030211 gastroenterology & hepatology Pharmacology (medical) lcsh:Diseases of the digestive system. Gastroenterology Esophagus lcsh:RC799-869 Adverse effect business |
| Zdroj: | Endoscopy International Open Endoscopy International Open, Vol 08, Iss 02, Pp E172-E178 (2020) |
| ISSN: | 2196-9736 2364-3722 |
| Popis: | Background and study aims Balloon cryoablation (BC) is a novel procedure for endoscopic ablation of Barrett’s esophagus (BE- associated neoplasia. We performed a meta-analysis to assess the feasibility, effectiveness, and safety of BC for treatment of BE neoplasia. Patients and methods Several databases were searched for relevant articles (PubMed, Web of Science, Google Scholar, EMBASE) as well as abstracts of recent gastroenterology meetings. Data extraction was performed by two investigators using standardized forms, including age, gender, length of BE segment, prior treatments, procedural time and number ablation sessions, technical feasibility, adverse events, and eradication rates of intestinal metaplasia (CE-IM) and dysplasia (CE-D) at follow-up. Quality of the studies was assessed using a modified Newcastle Ottawa Scale. Results Seven studies met inclusion criteria for a total of 548 ablation sessions in 272 patients. The most common histopathology reported prior to BC was high-grade dysplasia (n = 131), followed by low-grade dysplasia (n = 75), and intramucosal adenocarcinoma (n = 52). The pooled rate for technical feasibility was 95.8 % (95 % CI: 93.6–97.5 %; I2 = 13.2 %; P = 0.3). Pooled rates of CE-IM and CE-D were 85.8 % (95 % CI: 77.8–92.2 %, I2 = 55.5 %; p = 0.04) and 93.8 % (95 % CI: 85.5–98.7 %, I2 = 74.2 %; P = 0.001), respectively. The overall adverse event (AE) rate was 12.5 % (34 out of 272 patients), of which stricture formation was the most common (5.8 %), followed by mucosal laceration (0.7 %), perforation (0.4 %), and bleeding (0.4 %). All AEs were successfully managed endoscopically. Conclusion This meta-analysis suggests that BC is a safe and effective ablative technique for treatment of BE neoplasia; future prospective comparative trials are needed to corroborate these initial findings. |
| Databáze: | OpenAIRE |
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