Hybrid argon plasma coagulation in Barrett's esophagus: a systematic review and meta-analysis

Sagar N. Shah; Nabil El Hage Chehade; Amirali Tavangar; Alyssa Choi; Marc Monachese; Kenneth J. Chang; Jason B. Samarasena

doi:10.5946/ce.2022.179

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저자정보: Sagar N. Shah (Department of Internal Medicine Los Angeles Medical Center University of California Los Angeles CA USA) Nabil El Hage Chehade (Division of Internal Medicine MetroHealth Medical Center Case Western Reserve University Cleveland OH USA) Amirali Tavangar (H.H. Chao Comprehensive Digestive Disease Center and Division of Gastroenterology/Hepatology University of California Irvine CA USA) Alyssa Choi (H.H. Chao Comprehensive Digestive Disease Center and Division of Gastroenterology/Hepatology University of California Irvine CA USA) Marc Monachese (H.H. Chao Comprehensive Digestive Disease Center and Division of Gastroenterology/Hepatology University of California Irvine CA USA) Kenneth J. Chang (H.H. Chao Comprehensive Digestive Disease Center and Division of Gastroenterology/Hepatology University of California Irvine CA USA) Jason B. Samarasena (H.H. Chao Comprehensive Digestive Disease Center and Division of Gastroenterology/Hepatology University of California Irvine CA USA)

저널정보: 대한소화기내시경학회 Clinical Endoscopy Clinical Endoscopy 제56권 제1호

발행연도: 2023.1

수록면: 38 - 49 (12page)

DOI: 10.5946/ce.2022.179

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Background/Aims: Patients with Barrett’s esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapiesaim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injectionto create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis toevaluate the safety and efficacy of hybrid-APC. Methods: We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplasticand non-dysplastic Barrett’s esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures includedcomplete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessaryto achieve CR-IM. Results: Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872–0.939;I2=0%). Pooled stricture rate was 2.0% (95% CI, 0.005–0.042; I2=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007–0.055;I2=0%). Conclusions: Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safetyprofile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlledtrials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparableto the current standards of care.

#Barrett esophagus #Esophageal stenosis #Hybrid argon plasma coagulation

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Sagar N. Shah

소속기관 Department of Internal Medicine Los Angeles Medical Center University of California Los Angeles CA USA

주요연구분야 의약학 > 임상의학 > 내과학

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Nabil El Hage Chehade

소속기관 Division of Internal Medicine MetroHealth Medical Center Case Western Reserve University Cleveland OH USA

주요연구분야 의약학 > 임상의학 > 내과학

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Amirali Tavangar