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Tuesday Poster Session

Category: Esophagus

P3272 - Efficacy and Safety of Argon Plasma Coagulation for the Ablation of Barrett’s Esophagus – A Systemic Review and Meta-Analysis

Tuesday, October 24, 2023
10:30 AM – 4:00 PM PT
Location: Exhibit Hall
Has Audio

    Presenting Author(s)

  • Marko Kozyk, MD

    Corewell Health William Beaumont University Hospital
    Royal Oak, MI

Marko Kozyk, MD1, Lohith Kumar, MD2, Kateryna Strubchevska, MD1, Manan Trivedi, MD3, Margaret Wasvary, BS4, Suprabhat Giri, MD2
1Corewell Health William Beaumont University Hospital, Royal Oak, MI; 2Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India; 3KB Bhabha Hospital, Mumbai, Maharashtra, India; 4Wayne State School of Medicine, Detroit, MI

Introduction: Argon Plasma Coagulation (APC) is an alternate ablative method to radiofrequency ablation (RFA) for the treatment of Barrett’s esophagus (BE), preferred due to its lower cost and widespread availability. The present meta-analysis aimed at analyzing the safety and efficacy of APC for the management of BE.

Methods: A literature search from January 2000 to November 2022 was done for studies analyzing the outcome of APC in BE. The primary outcomes were clearance rate of intestinal metaplasia (CR-IM) and adverse events (AE). Pooled event rates were expressed with summative statistics.

Results: A total of 38 studies were included in the final analysis. The pooled event rate for CR-IM with APC in BE was 86.8% (95% CI: 83.5 – 90.2), with high-power and hybrid APC having a higher rate compared to standard APC. The pooled incidence of AE with APC in BE was 22.5% (95% CI: 15.3 – 29.7), without any significant difference between the subgroups, with self-limited chest pain being the commonest AE. The incidence of serious AE was only 0.4% (95% CI: 0.0 – 1.0), while stricture development was seen only in 1.7% (95% CI: 0.9 – 2.6) of cases. The pooled recurrence rate of BE was 16.1% (95% CI: 10.7 – 21.6), with a significantly lower recurrence with high-power APC than standard APC.

Discussion: High-power and hybrid APC seem to have an advantage over standard APC in terms of clearance rate and recurrence rate. Further studies are required to compare the efficacy and safety of hybrid APC with standard APC and RFA.

Parameters

Overall

Standard APC

High-power APC

Hybrid APC

CR-IM

86.8%

(83.5 – 90.2)

I2 = 86.2%

78.5%

(71.7 – 85.4)

I2 = 90.9%

98.6%

(96.1 – 100.0)

I2 = 49.2%

89.6%

(83.8 – 95.5)

I2 = 50.9%

Adverse events

22.5%

(15.3 – 29.7)

I2 = 93.9%

17.2%

(9.3 – 25.1)

I2 = 90.7%

25.5%

(9.7 – 41.3)

I2 = 91.6%

13.6%

(2.6 – 24.7)

I2 = 85.1%

Serious adverse events

0.4%

(0.0 – 1.0)

I2 = 0.0%

0.1%

(0.0 – 0.9)

I2 = 0.0%

0.4%

(0.0 – 1.6)

I2 = 0.0%

1.1%

(0.0 – 2.5)

I2 = 0.0%

Stricture

1.7%

(0.9 – 2.6)

I2 = 0.0%

1.0%

(0.0 – 2.1)

I2 = 0.0%

3.0%

(0.9 – 5.1)

I2 = 0.0%

2.6%

(0.7 – 4.6)

I2 = 0.0%

Recurrence

16.1%

(10.7 – 21.6)

I2 = 88.8%

21.2%

(12.2 – 30.2)

I2 = 88.3%

7.3%

(0.4 – 14.2)

I2 = 74.3%

14.7%

(0.0 – 30.0)

I2 = 87.1%

APC: Argon plasma coagulation; CR-IM: Clearance rate for intestinal metaplasia



Disclosures:
Marko Kozyk indicated no relevant financial relationships.
Lohith Kumar indicated no relevant financial relationships.
Kateryna Strubchevska indicated no relevant financial relationships.
Manan Trivedi indicated no relevant financial relationships.
Margaret Wasvary indicated no relevant financial relationships.
Suprabhat Giri indicated no relevant financial relationships.


Marko Kozyk, MD1, Lohith Kumar, MD2, Kateryna Strubchevska, MD1, Manan Trivedi, MD3, Margaret Wasvary, BS4, Suprabhat Giri, MD2. P3272 - Efficacy and Safety of Argon Plasma Coagulation for the Ablation of Barrett’s Esophagus – A Systemic Review and Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.