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 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.

CONCLUSION: EBL is superior to APC in the treatment of GAVE in terms of endoscopic eradication rates, recurrence of bleeding, and transfusion requirements.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:54

Enthalten in:

Clinical endoscopy - 54(2021), 5 vom: 01. Sept., Seite 669-677

Sprache:

Englisch

Beteiligte Personen:

Hirsch, Bruno Salomão [VerfasserIn]
Ribeiro, Igor Braga [VerfasserIn]
Funari, Mateus Pereira [VerfasserIn]
de Moura, Diogo Turiani Hourneaux [VerfasserIn]
Matuguma, Sergio Eiji [VerfasserIn]
Sánchez-Luna, Sergio A [VerfasserIn]
Mancini, Fabio Catache [VerfasserIn]
de Oliveira, Guilherme Henrique Peixoto [VerfasserIn]
Bernardo, Wanderley Marques [VerfasserIn]
de Moura, Eduardo Guimarães Hourneaux [VerfasserIn]

Links:

Volltext

Themen:

Argon plasma coagulation
Endoscopic band ligation
Endoscopy
Gastric antral vascular ectasia
Journal Article

Anmerkungen:

Date Revised 22.10.2021

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.5946/ce.2021.063

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM326018662