PDF(Pubmed)
Abstract：
OBJECTIVE: Radiofrequency ablation (RFA) is the first-line therapy for dysplastic Barrett\'s esophagus (BE). Therefore, cryotherapy has emerged as an alternative treatment option. This study aimed to compare the efficacies of these two techniques based on the rates of complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). Adverse events and recurrence have also been reported.
METHODS: An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS: Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], -0.03; 95% confidence interval [CI], -0.25 to 0.19; p=0.78; I2=86%) as well as in CE-D (RD, -0.03; 95% CI, -0.15 to 0.09; p=0.64; I2=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate.
CONCLUSIONS: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.
METHODS: An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS: Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], -0.03; 95% confidence interval [CI], -0.25 to 0.19; p=0.78; I2=86%) as well as in CE-D (RD, -0.03; 95% CI, -0.15 to 0.09; p=0.64; I2=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate.
CONCLUSIONS: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.
摘要：
■射频消融（RFA）是治疗发育不良Barrett食管（BE）的一线治疗方法。因此,冷冻疗法已成为一种替代治疗选择。本研究旨在根据肠上皮化生（CE-IM）和发育不良（CE-D）的完全根除率比较这两种技术的有效性。不良事件和复发也有报道。
■使用Medline（PubMed）进行了电子搜索，Embase,LILACS,和谷歌学术数据库，直到2022年12月。包括比较冷冻疗法和RFA治疗有或没有早期食管肿瘤的发育不良BE的研究。这项研究是根据系统评价和荟萃分析指南的首选报告项目进行的。
■纳入了三个回顾性队列研究，涉及627名患者。其中,399例患者接受RFA，228例接受冷冻治疗。CE-IM没有差异(风险差异[RD]，-0.03；95%置信区间[CI]，-0.25至0.19；p=0.78；I2=86%）以及CE-D（RD，组间-0.03；95%CI，-0.15至0.09；p=0.64；I2=70%）。不良事件的绝对数量较低，复发率无差异。
■冷冻疗法和RFA在治疗发育不良的BE方面同样有效，有或没有早期食管肿瘤。
■使用Medline（PubMed）进行了电子搜索，Embase,LILACS,和谷歌学术数据库，直到2022年12月。包括比较冷冻疗法和RFA治疗有或没有早期食管肿瘤的发育不良BE的研究。这项研究是根据系统评价和荟萃分析指南的首选报告项目进行的。
■纳入了三个回顾性队列研究，涉及627名患者。其中,399例患者接受RFA，228例接受冷冻治疗。CE-IM没有差异(风险差异[RD]，-0.03；95%置信区间[CI]，-0.25至0.19；p=0.78；I2=86%）以及CE-D（RD，组间-0.03；95%CI，-0.15至0.09；p=0.64；I2=70%）。不良事件的绝对数量较低，复发率无差异。
■冷冻疗法和RFA在治疗发育不良的BE方面同样有效，有或没有早期食管肿瘤。
