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
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 treatm...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2021-09-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2021-063.pdf |
| _version_ | 1797668369476878336 |
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| author | Bruno Salomão Hirsch Igor Braga Ribeiro Mateus Pereira Funari Diogo Turiani Hourneaux de Moura Sergio Eiji Matuguma Sergio A. Sánchez-Luna Fabio Catache Mancini Guilherme Henrique Peixoto de Oliveira Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura |
| author_facet | Bruno Salomão Hirsch Igor Braga Ribeiro Mateus Pereira Funari Diogo Turiani Hourneaux de Moura Sergio Eiji Matuguma Sergio A. Sánchez-Luna Fabio Catache Mancini Guilherme Henrique Peixoto de Oliveira Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura |
| author_sort | Bruno Salomão Hirsch |
| collection | DOAJ |
| description | 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]; I2=0%) and less bleeding recurrence than APC (RD, 0.29; 95% CI [0.15, 0.44]; I2=0%). Patients treated with EBL required fewer blood transfusions (mean difference [MD], 1.49; 95% CI [0.28, 2.71]; I2=96%) and hospitalizations (MD, 0.29; 95% CI [0.19, 0.39]; I2=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. |
| first_indexed | 2024-03-11T20:27:11Z |
| format | Article |
| id | doaj.art-56e2b19896f64d79b2fa720959b3a9ae |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T20:27:11Z |
| publishDate | 2021-09-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-56e2b19896f64d79b2fa720959b3a9ae2023-10-02T11:44:08ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432021-09-0154566967710.5946/ce.2021.0637539Endoscopic Band Ligation Versus Argon Plasma Coagulation in the Treatment of Gastric Antral Vascular Ectasia: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsBruno Salomão Hirsch0Igor Braga Ribeiro1Mateus Pereira Funari2Diogo Turiani Hourneaux de Moura3Sergio Eiji Matuguma4Sergio A. Sánchez-Luna5Fabio Catache Mancini6Guilherme Henrique Peixoto de Oliveira7Wanderley Marques Bernardo8Eduardo Guimarães Hourneaux de Moura9 Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, Brazil Center for Advanced Endoscopy, Division of Gastroenterology, Hepatology, and Nutrition, Allegheny Health Network, Pittsburgh, Pennsylvania, USA Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, Brazil Gastrointestinal Endoscopy Unit, Hospital das Clínicas, University of Sao Paulo School of Medicine, São Paulo, BrazilBackground/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]; I2=0%) and less bleeding recurrence than APC (RD, 0.29; 95% CI [0.15, 0.44]; I2=0%). Patients treated with EBL required fewer blood transfusions (mean difference [MD], 1.49; 95% CI [0.28, 2.71]; I2=96%) and hospitalizations (MD, 0.29; 95% CI [0.19, 0.39]; I2=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.http://www.e-ce.org/upload/pdf/ce-2021-063.pdfargon plasma coagulationendoscopic band ligationendoscopygastric antral vascular ectasia |
| spellingShingle | Bruno Salomão Hirsch Igor Braga Ribeiro Mateus Pereira Funari Diogo Turiani Hourneaux de Moura Sergio Eiji Matuguma Sergio A. Sánchez-Luna Fabio Catache Mancini Guilherme Henrique Peixoto de Oliveira Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura 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 Clinical Endoscopy argon plasma coagulation endoscopic band ligation endoscopy gastric antral vascular ectasia |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | argon plasma coagulation endoscopic band ligation endoscopy gastric antral vascular ectasia |
| url | http://www.e-ce.org/upload/pdf/ce-2021-063.pdf |
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