Endoscopic Band Ligation Versus Argon Plasma Coagulation in the Treatment of Gastric Antral Vascular Ectasia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

被引:13
作者
Hirsch, Bruno Salomao [1 ]
Ribeiro, Igor Braga [1 ]
Funari, Mateus Pereira [1 ]
Hourneaux de Moura, Diogo Turiani [1 ]
Matuguma, Sergio Eiji [1 ]
Sanchez-Luna, Sergio A. [2 ,3 ]
Mancini, Fabio Catache [1 ]
Peixoto de Oliveira, Guilherme Henrique [1 ]
Bernardo, Wanderley Marques [1 ]
Hourneaux de Moura, Eduardo Guimaraes [1 ]
机构
[1] Univ Sao Paulo, Hosp Clin, Gastrointestinal Endoscopy Unit, Sch Med, Av Dr Eneas Carvalho Aguiar 225,6o Ander,Bloco 3, BR-05403010 Sao Paulo, Brazil
[2] Allegheny Hlth Network, Div Gastroenterol Hepatol & Nutr, Ctr Adv Endoscopy, Pittsburgh, PA USA
[3] Univ Alabama Birmingham, Basil I Hirschowitz Endoscop Ctr Excellence, Dept Internal Med, Div Gastroenterol & Hepatol, Birmingham, AL USA
关键词
Argon plasma coagulation; Endoscopic band ligation; Endoscopy; Gastric antral vascular ectasia; WATERMELON STOMACH; RADIOFREQUENCY ABLATION; CLINICAL PRESENTATION; DIAGNOSIS; GAVE; COMPLICATION; GASTROPATHY; MANAGEMENT; POLYPS;
D O I
10.5946/ce.2021.063
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: Argon plasma coagulation (APC) is the most commonly used endoscopic treatment for gastric antral vascular ectasia (GAVE). Endoscopic band ligation (EBL) has emerged as an alternative therapy. Our goal was to evaluate the feasibility, efficacy, and safety of APC and EBL for the treatment of GAVE. This is the first systematic review that included only randomized controlled trials (RCTs) on this topic. Methods: A comprehensive search was performed using electronic databases to identify RCTs comparing APC and EBL for the treatment of GAVE following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Results: Four RCTs were included, with a total of 204 patients. EBL was related to higher endoscopic eradication rates risk difference [RD], 0.29; 95% confidence interval [CI] [0.14, 0.44]; I-2=0%) and less bleeding recurrence than APC (RD, 0.29; 95% CI [0.15, 0.44]; I-2=0%). Patients treated with EBL required fewer blood transfusions (mean difference [MD], 1.49; 95% CI [0.28, 2.71]; I-2=96%) and hospitalizations (MD, 0.29; 95% CI [0.19, 0.39]; I-2=0%). The number of sessions required for the obliteration of lesions was higher with APC. There was no difference in the incidence of adverse events. Conclusions: EBL is superior to APC in the treatment of GAVE in terms of endoscopic eradication rates, recurrence of bleeding, and transfusion requirements.
引用
收藏
页码:669 / 677
页数:9
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