Por favor, use este identificador para citar o enlazar este ítem: https://observatorio.fm.usp.br/handle/OPI/31997
Título: Treatment of high-grade dysplasia and intramucosal carcinoma using radiofrequency ablation or endoscopic mucosal resection
Autor: MATOS, Mileine Valente dePONTE-NETO, Alberto Machado daMOURA, Diogo Turiani Hourneaux deMAAHS, Ethan DwaneCHAVES, Dalton MarquesBABA, Elisa RyokaIDE, EdsonSALLUM, RubensBERNARDO, Wanderley MarquesMOURA, Eduardo Guimaraes Hourneaux de
Citación: WORLD JOURNAL OF GASTROINTESTINAL ENDOSCOPY, v.11, n.3, p.239-248, 2019
Resumen: 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.
Aparece en las colecciones:

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - HC/Outros
Outros institutos - HC/Outros

Artigos e Materiais de Revistas Científicas - LIM/35
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo


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