Hybrid argon plasma coagulation for Barrett’s esophagus – a systematic review and meta-analysis

Aims Hybrid argon plasma coagulation (hAPC) is a novel technique that combines conventional argon plasma coagulation and waterjet submucosal expansion. Recent studies have evaluated its efficacy and safety in the setting of Barret’s esophagus (BE) ablation. The authors aimed to systematically review these studies.

Methods Four electronic databases were searched from inception up to the 15th of September 2022. Studies were selected and analyzed by two independent authors. Then, random-effects meta-analyses of the proportions of endoscopic and histologic remission, recurrence, and post-procedure adverse events were performed using R. Studies’ reporting quality was independently assessed.

Results From the 780 identified records, 10 studies were included. The pooled percentages of endoscopic and histologic remission after hAPC were 95% (95% confidence interval [CI] 91-99, I²=34) and 90% (95%CI 84-95, I²=46), respectively, while major adverse events and recurrence were registered in 2% (95%CI 0-5, I²=41) and 11% (95%CI 2-27, I²=11), respectively. Studies’ quality was considered moderate; however external validity was low.

Conclusions Even though the ability to extrapolate findings remains limited due to studies’ characteristics and reporting quality, evidence suggests hAPC is effective and safe; being the later characteristic the greater advantage when this technique is indirectly compared to those currently under use (argon plasma coagulation and radiofrequency ablation). Prospective comparative trials may shed light on this topic.

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
14 April 2023