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Abstract：
Hybrid argon plasma coagulation (hAPC) is a novel technique that combines conventional argon plasma coagulation and waterjet submucosal expansion. The aims of this metanalysis were to evaluate the efficacy and safety of hAPC in the setting of Barret\'s esophagus (BE) ablation and as an adjunct to colonic endoscopic mucosal resection (EMR). Four electronic databases were searched, and the results were analyzed by two independent authors. Random-effects meta-analyses of the proportions of endoscopic and histologic remission (for BE), recurrence, and post-procedure adverse events were performed using R. Studies\' reporting quality was also assessed. From the 979 identified records, 13 studies were included (10 regarding BE and three colonic EMR). The pooled percentages of endoscopic and histologic remission after hAPC for BE were 95% (95% confidence interval [CI] 91-99, I2 = 34) and 90% (95%CI 84-95, I2 = 46), respectively, while major adverse events and recurrence were registered in 2% (95%CI 0-5, I2 = 41) and 11% (95%CI 2-27, I2 = 11), respectively. Concerning hAPC-assisted EMR, the pooled percentages of major adverse events and recurrence were 5% (95%CI 2-10, I2 = 0) and 1% (95%CI 0-3, I2 = 40). Evidence suggests that the main advantages of hAPC are the increase in safety in the setting of BE ablation and the reduction of local recurrence after colonic EMR. Trials comparing hAPC with standard strategies are required to support its use for these indications.
摘要：
混合氩等离子体凝固术（hAPC）是一种结合常规氩等离子体凝固术和水射流粘膜下扩张术的新技术。这项分析的目的是评估hAPC在Barret食管（BE）消融中的疗效和安全性，以及作为结肠内镜粘膜切除术（EMR）的辅助手段。搜索了四个电子数据库，结果由两名独立作者进行分析。内窥镜和组织学缓解比例的随机效应荟萃分析（对于BE），复发,和术后不良事件使用R进行。还评估了研究报告质量。从979条确定的记录中，纳入13项研究(10项关于BE和3项结肠EMR)。对于BE，hAPC后内镜和组织学缓解的合并百分比为95％（95％置信区间[CI]91-99，I2=34）和90％（95CI84-95，I2=46），分别,而主要不良事件和复发分别为2％（95CI0-5，I2=41）和11％（95CI2-27，I2=11），分别。关于hAPC辅助的EMR，主要不良事件和复发的合并百分比分别为5%(95CI2-10,I2=0)和1%(95CI0-3,I2=40).有证据表明，hAPC的主要优点是增加了BE消融的安全性，并减少了结肠EMR后的局部复发。需要将hAPC与标准策略进行比较的试验，以支持其用于这些适应症。
