Please use this identifier to cite or link to this item:
https://observatorio.fm.usp.br/handle/OPI/31997
Title: | Treatment of high-grade dysplasia and intramucosal carcinoma using radiofrequency ablation or endoscopic mucosal resection |
Authors: | MATOS, Mileine Valente de; PONTE-NETO, Alberto Machado da; MOURA, Diogo Turiani Hourneaux de; MAAHS, Ethan Dwane; CHAVES, Dalton Marques; BABA, Elisa Ryoka; IDE, Edson; SALLUM, Rubens; BERNARDO, Wanderley Marques; MOURA, Eduardo Guimaraes Hourneaux de |
Citation: | WORLD JOURNAL OF GASTROINTESTINAL ENDOSCOPY, v.11, n.3, p.239-248, 2019 |
Abstract: | BACKGROUND The progression of Barrett's esophagus (BE) to early esophageal carcinoma occurs sequentially; the metaplastic epithelium develops from a low-grade dysplasia to a high-grade dysplasia (HGD), resulting in early esophageal carcinoma and, eventually, invasive carcinoma. Endoscopic approaches including resection and ablation can be used in the treatment of this condition. AIM To compare the effectiveness of radiofrequency ablation (RFA) vs endoscopic mucosal resection (EMR) + RFA in the endoscopic treatment of HGD and intramucosal carcinoma. METHODS In accordance with PRISMA guidelines, this systematic review included studies comparing the two endoscopic techniques (EMR + RFA and RFA alone) in the treatment of HGD and intramucosal carcinoma in patients with BE. Our analysis included studies involving adult patients of any age with BE with HGD or intramucosal carcinoma. The studies compared RFA and EMR + RFA methods were included regardless of randomization status. RESULTS The seven studies included in this review represent a total of 1950 patients, with 742 in the EMR + RFA group and 1208 in the RFA alone group. The use of EMR + RFA was significantly more effective in the treatment of HGD [RD 0.35 (0.15, 0.56)] than was the use of RFA alone. The evaluated complications (stenosis, bleeding, and thoracic pain) were not significantly different between the two groups. CONCLUSION Endoscopic resection in combination with RFA is a safe and effective method in the treatment of HGD and intramucosal carcinoma, with higher rates of remission and no significant differences in complication rates when compared to the use of RFA alone. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - HC/InCor Artigos e Materiais de Revistas Científicas - HC/Outros Artigos e Materiais de Revistas Científicas - LIM/35 |
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art_MATOS_Treatment_of_highgrade_dysplasia_and_intramucosal_carcinoma_using_2019.PDF | publishedVersion (English) | 1.96 MB | Adobe PDF | View/Open |
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