Hybrid argon plasma coagulation in Barrett’s esophagus: a systematic review and meta-analysis
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
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.
Abstract
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.
참고문헌 (45)
- Burke ZD, "Barrett’s metaplasia as a paradigm for understanding the development of cancer", Curr Opin Genet Dev, 22, pp.494~499 (2012)
- Wang DH, "Aberrant epithelial-mesenchymal Hedgehog signaling characterizes Barrett’s metaplasia", Gastroenterology, 138, pp.1810~1822 (2010)
- Lagergren J, "Recent developments in esophageal adenocarcinoma", CA Cancer J Clin, 63, pp.232~248 (2013)
- Shaheen NJ, "ACG clinical guideline : diagnosis and management of Barrett’s esophagus", Am J Gastroenterol, 111, pp.30~50 (2016)
- Pech O, "Long-term efficacy and safety of endoscopic resection for patients with mucosal adenocarcinoma of the esophagus", Gastroenterology, 146, pp.652~660 (2014)
- Kolb JM, "Endoscopic eradication therapy for Barrett’s oesophagus : state of the art", Curr Opin Gastroenterol, 36, pp.351~358 (2020)
- Garman KS, "Ablative therapies for Barrett’s esophagus", Curr Gastroenterol Rep, 13, pp.226~239 (2011)
- Ganz RA, "Complete ablation of esophageal epithelium with a balloon-based bipolar electrode : a phased evaluation in the porcine and in the human esophagus", Gastrointest Endosc, 60, pp.1002~1010 (2004)
- Dunkin BJ, "Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device", Surg Endosc, 20, pp.125~130 (2006)
- van Vilsteren FG, "Stepwise radical endoscopic resection versus radiofrequency ablation for Barrett’s oesophagus with high-grade dysplasia or early cancer : a multicentre randomised trial", Gut, 60, pp.765~773 (2011)
- Kolb JM, "Hybrid argon plasma coagulation for Barrett’s esophagus", VideoGIE, 6, pp.339~341 (2021)
- Moher D, "Preferred reporting items for systematic reviews and meta-analyses : the PRISMA statement", Ann Intern Med, 151, pp.264~269 (2009)
- Cotton PB, "A lexicon for endoscopic adverse events : report of an ASGE workshop", Gastrointest Endosc, 71, pp.446~454 (2010)
- Hozo SP, "Estimating the mean and variance from the median, range, and the size of a sample", BMC Med Res Methodol, 5, pp.13~ (2005)
- Peterson J, "The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis", Ottawa Hospital Research Institute, 1~12 (2011)
- Murad MH, "Methodological quality and synthesis of case series and case reports", BMJ Evid Based Med, 23, pp.60~63 (2018)
- Bazerbachi F, "Metal stents versus plastic stents for the management of pancreatic walled-off necrosis : a systematic review and meta-analysis", Gastrointest Endosc, 87, pp.30~42 (2018)
- Lin L, "Arcsine-based transformations for meta-analysis of proportions : pros, cons, and alternatives", Health Sci Rep, 3, pp.e178~ (2020)
- Nyaga VN, "Metaprop : a Stata command to perform meta-analysis of binomial data", Arch Public Health, 72, pp.39~ (2014)
- Egger M, "Bias in meta-analysis detected by a simple, graphical test", BMJ, 315, pp.629~634 (1997)
- Easterbrook PJ, "Publication bias in clinical research", Lancet, 337, pp.867~872 (1991)
- Viechtbauer W, "Conducting meta-analyses in R with the metafor package", J Stat Softw, 36, pp.1~48 (2010)
- Barker TH, "Conducting proportional meta-analysis in different types of systematic reviews : a guide for synthesisers of evidence", BMC Med Res Methodol, 21, pp.189~ (2021)
- Han J, "Efficacy, tolerance, and safety of hybrid argon plasma coagulation for the treatment of Barrett’s esophagus : a US pilot study", Am J Gastroenterol, 113, pp.S213~ (2018)
- Nieto J, "935 Salvage hybrid APC after failed radiofrequency ablation and cryotherapy for Barrett’s esophagus", Am J Gastroenterol, 114, pp.S544~ (2019)
- Kroupa R, "Hybrid argon plasma coagulation in the ablation treatment of Barrett’s esophagus-long term results", United European Gastroenterol J, 9(Supplement), pp.297~ (2021)
- Trindade AJ, "Successful treatment of refractory Barrett’s neoplasia with hybrid argon plasma coagulation : a case series", Endoscopy, 52, pp.812~813 (2020)
- Arshad HM, "Safety and efficacy of endoscopic hybridapc for management of Barrett’s esophagus", Gastrointest Endosc, 85(5 Supplement), pp.AB562~AB563 (2017)
- Dominic Andre Staudenmann, "Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett’s esophagus: An Australian pilot study (with video)", International Journal of Gastrointestinal Intervention, 10(3), pp.128~132 (2021), 소화기인터벤션의학회[DOI]
- Knabe M, "Hybrid APC in combination with resection for the endoscopic treatment of neoplastic Barrett’s esophagus : a prospective, multicenter study", Am J Gastroenterol, 117, pp.110~119 (2022)
- Manner H, "Efficacy and safety of hybrid-APC for the ablation of Barrett’s esophagus", Surg Endosc, 30, pp.1364~1370 (2016)
- Rösch T, "Multicenter feasibility study of combined injection and argon plasma coagulation(Hybrid-APC)in the ablation therapy of neoplastic Barrett esophagus", Gastrointest Endosc, 85(5 Supplement), pp.AB154~ (2017)
- Linn B, "Hybrid argon plasma coagulation and radiofrequency ablation in Barrett’s esophagus", Gastrointest Endosc, 91(6 Supplement), pp.AB413~ (2020)
- Kashin SV, "The new hybrid argon plasma coagulation(hybrid APC)for endoscopic ablation of Barrett’s esophagus(BE) : the results of the pilot trial", Gastrointest Endosc, 83(5 Supplement), pp.AB495~ (2016)
- Shimizu T, "Benefit, tolerance, and safety of hybrid argon plasma coagulation for treatment of Barrett’s esophagus : US pilot study", Endosc Int Open, 9, pp.E1870~ (2021)
- Manner H, "The tissue effect of argon-plasma coagulation with prior submucosal injection(Hybrid-APC)versus standard APC : a randomized ex-vivo study", United European Gastroenterol J, 2, pp.383~390 (2014)
- Norton ID, "Efficacy of colonic submucosal saline solution injection for the reduction of iatrogenic thermal injury", Gastrointest Endosc, 56, pp.95~99 (2002)
- Qumseya BJ, "Adverse events after radiofrequency ablation in patients with Barrett’s esophagus : a systematic review and meta-analysis", Clin Gastroenterol Hepatol, 14, pp.1086~1095 (2016)
- Pandey G, "Systematic review and meta-analysis of the effectiveness of radiofrequency ablation in low grade dysplastic Barrett’s esophagus", Endoscopy, 50, pp.953~960 (2018)
- Orman ES, "Efficacy and durability of radiofrequency ablation for Barrett’s esophagus : systematic review and meta-analysis", Clin Gastroenterol Hepatol, 11, pp.1245~1255 (2013)
- Desai M, "Systematic review with meta-analysis : the long-term efficacy of Barrett’s endoscopic therapy-stringent selection criteria and a proposal for definitions", Aliment Pharmacol Ther, 54, pp.222~233 (2021)
- Shaheen NJ, "Radiofrequency ablation in Barrett’s esophagus with dysplasia", N Engl J Med, 360, pp.2277~2288 (2009)
- Phoa KN, "Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia : a randomized clinical trial", JAMA, 311, pp.1209~1217 (2014)
- Spechler SJ, "Buried(but not dead)Barrett’s metaplasia : tales from the crypts", Gastrointest Endosc, 76, pp.41~43 (2012)
- Gray NA, "Buried metaplasia after endoscopic ablation of Barrett’s esophagus : a systematic review", Am J Gastroenterol, 106, pp.1899~1908 (2011)