Id: 3522400 Simplifed Versus Standard Radiofrequency Ablation Protocols for Dysplastic Barrett's Esophagus: A Systematic Review and Meta-Analysis

Shah, Sagar; Roccato, Mary Kathryn; Ji, Samuel S.; Jariwalla, Neil R.; Kozik, Spencer; Ortizo, Ronald D.; Kolb, Jennifer M.; Samarasena, Jason

doi:10.1016/j.gie.2021.03.991

Cited by 1 publication

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“…However, there have been several oral presentations and an abstract, which are summarised in a published meta-analysis [ 12 , 21 ]. The stricture rate using a simplified focal device at 3 × 12 J/cm 2 was between 7.5 and 18% [ 22 ], with Barrett’s eradication rates of 60–91.7% [ 12 , 21 ]. Only one large prospective, randomised study has investigated APC and RFA together.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation versus hybrid argon plasma coagulation in Barrett’s esophagus: a prospective randomised trial

Knabe,

Wetzka,

Welsch

et al. 2023

Surg Endosc

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Introduction Radiofrequency ablation (RFA) and hybrid argon plasma coagulation (H-APC) are established thermal ablation techniques for eradicating Barrett’s esophagus after endoscopic resection. This study aimed to compare RFA with H-APC in relation to safety, effectiveness and eradication rates. Methods After endoscopic resection, patients were randomly assigned to H-APC or RFA. A simplified H-APC technique was applied at 60 W. RFA was used with a 90° focal catheter and a simplified protocol of 12 J/cm2 × 3 or with a Halo 360° balloon and 10 J/cm2/cleaning/10 J/cm2. Eradication rates and adverse events were recorded. Patients received follow-up examinations after 3, 6, 12 and 24 months. Results One hundred and one patients were finally included in the study (RFA N = 47, H-APC N = 54). The median follow-up period for short-term was 6.0 (CI 5.4–6.9) months and for long term 21 (CI 19.2.5–22.7) months. In total 211 ablations were performed. The eradication rates after long-term follow-up were 74.2% in the RFA group and 82.9% in the H-APC group. Post-interventional pain was significantly greater in the RFA group, with a mean score of 4.56/10 and duration of 7.54 days, in comparison with a mean score of 2.07/10 over 3.59 days in the H-APC group. Stenoses requiring intervention were noted in 3.7% of patients in the H-APC arm and 14.9% of those in the RFA arm. Conclusions Both ablation techniques have good results in relation to the eradication rate, with a slightly better outcome in the H-APC group. The severity and duration of pain were significantly greater in the RFA group.

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