Systematic review and meta-analysis of the effectiveness of radiofrequency ablation in low grade dysplastic Barrett's esophagus.
Endoscopy
; 50(10): 953-960, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-29689573
ABSTRACT
BACKGROUND:
Barrett's esophagus (BE) is a premalignant condition characterized by replacement of the esophageal lining with metastatic columnar epithelium, and its management when complicated by low grade dysplasia (LGD) is controversial. This systematic review and meta-analysis aimed to determine the efficacy of radiofrequency ablation (RFA) in patients with LGD.METHODS:
MEDLINE, EMBASE, and Web of Science were searched for studies including patients with BE-associated LGD receiving RFA (January 1990 to May 2017). The outcome measures were complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D), rates of progression to high grade dysplasia (HGD) or cancer, and recurrence.RESULTS:
Eight studies including 619 patients with LGD (RFAâ=â404, surveillanceâ=â215) were analyzed. After a median follow-up of 26 months (range 12â-â44 months), the overall pooled rates of CE-IM and CE-D after RFA were 88.17â% (95â% confidence interval [CI] 88.13â%â-â88.20â%; Pâ<â0.001) and 96.69â% (95â%CI 96.67â%â-â96.71â%; Pâ<â0.001), respectively. When compared with surveillance, RFA resulted in significantly lower rates of progression to HGD or cancer (odds ratio [OR] 0.07, 95â%CI 0.02â-â0.22). The pooled recurrence rates of IM and dysplasia were 5.6â% (95â%CI 5.57â-â5.63; Pâ<â0.001) and 9.66â% (95â%CI 9.61â-â9.71; Pâ<â0.001), respectively.CONCLUSIONS:
RFA safely eradicates IM and dysplasia and reduces the rates of progression from LGD to HGD or cancer in the short term.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Esôfago de Barrett
/
Neoplasias Esofágicas
/
Ablação por Radiofrequência
Tipo de estudo:
Etiology_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Reino Unido