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Nabil El Hage Chehade 1 Article
Hybrid argon plasma coagulation in Barrett’s esophagus: a systematic review and meta-analysis
Sagar N. Shah, Nabil El Hage Chehade, Amirali Tavangar, Alyssa Choi, Marc Monachese, Kenneth J. Chang, Jason B. Samarasena
Clin Endosc 2023;56(1):38-49.   Published online January 30, 2023
DOI: https://doi.org/10.5946/ce.2022.179
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Patients with Barrett’s esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate 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 dysplastic and non-dysplastic Barrett’s esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to 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 safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.

Citations

Citations to this article as recorded by  
  • Application of electrosurgery in gastrointestinal endoscopy

    Progress in Medical Devices.2024;[Epub]     CrossRef
  • Hybrid Argon Plasma Coagulation for Barrett’s Esophagus and for Colonic Mucosal Resection—A Systematic Review and Meta-Analysis
    Maria Manuela Estevinho, Rolando Pinho, João Carlos Silva, João Correia, Pedro Mesquita, Teresa Freitas
    Biomedicines.2023; 11(4): 1139.     CrossRef
  • Hybrid-APC treatment for gastric vascular ectasia of atypical location after failed radiofrequency ablation
    José Manuel Palma García, Raúl Honrubia López, Cristina Fernández de Castro, Carmen Comas Redondo
    Revista Española de Enfermedades Digestivas.2023;[Epub]     CrossRef
  • Thermal ablative therapies in the gastrointestinal tract
    Hendrik Manner
    Current Opinion in Gastroenterology.2023; 39(5): 370.     CrossRef
  • Endoscopic Management of Dysplastic Barrett’s Oesophagus and Early Oesophageal Adenocarcinoma
    Leonardo Henry Eusebi, Andrea Telese, Chiara Castellana, Rengin Melis Engin, Benjamin Norton, Apostolis Papaefthymiou, Rocco Maurizio Zagari, Rehan Haidry
    Cancers.2023; 15(19): 4776.     CrossRef
  • Critical Decision Making: Technical Aspects of Esophageal Ablation
    Felice Schnoll-Sussman
    Foregut: The Journal of the American Foregut Society.2023; 3(3): 314.     CrossRef
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