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首页> 外文期刊>Endoscopy International Open >Safety and effectiveness of balloon cryoablation for treatment of Barrett’s associated neoplasia: systematic review and meta-analysis
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Safety and effectiveness of balloon cryoablation for treatment of Barrett’s associated neoplasia: systematic review and meta-analysis

机译：Barrett相关肿瘤治疗气球冷冻食用的安全性和有效性：系统评价和荟萃分析

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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?%; Isup2/sup?=?13.2?%; P?=?0.3). Pooled rates of CE-IM and CE-D were 85.8?% (95?% CI: 77.8–92.2?%, Isup2/sup?=?55.5?%; p?=?0.04) and 93.8?% (95?% CI: 85.5–98.7?%, Isup2/sup?=?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.
机译：背景和研究目标？气球冷冻膨胀（BC）是对巴雷特食管的内窥镜消融的新方法（相关的肿瘤。我们进行了荟萃分析，以评估BC治疗肿瘤的可行性，有效性和安全性。患者和方法？搜索有关的有关文章（PubMed，Science，Google Scholar，Embase）以及最近的胃肠学会议的摘要。通过两个调查人员使用标准化形式进行数据提取，包括年龄，性别，长度在随访时，分段，前后治疗，程序时间和数量消融会话，技术可行性，不良事件和肠道细胞（CE-IM）和发育不良（CE-D）的消除率。使用A评估研究的质量修改了纽卡斯尔渥太华规模。结果？七项研究在272名患者中共纳入548次消融会议。在BC之前报告的最常见的组织病理学很高 - 等级发育不良（n？=α131），然后是低级发育不良（n？=α75）和腔内腺癌（n？=Δ52）。技术可行性的汇集率为95.8？％（95？％CI：93.6-97.5？％; I 2 ？=？13.2？％; p？= 0.3）。 CE-IM和CE-D的汇总率为85.8？％（95〜％CI：77.8-92.2？％，I 2 ？=？55.5？％; p？= 0.04）和93.8 ？％（95？％CI：85.5-98.7？％，I 2 ？=？74.2？％; p？= 0.001）。总体不良事件（AE）率为12.5？％（272名患者中的34例），其中狭窄形成是最常见的（5.8？％），其次是粘膜损伤（0.7？％），穿孔（0.4？％） ，出血（0.4？％）。所有AES都在内窥镜上成功管理。结论？这种荟萃分析表明，BC是一种安全有效的嗜肥技术，用于治疗肿瘤;需要未来的前瞻性比较试验来证实这些初步结果。

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