Evidence-based strategies to the clinical management of Barrett’s esophagus are lacking.
Dr You-Ming Li and colleagues from China carried out a systematic review and meta-analysis of all published randomized controlled trials.
The team evaluated the value of different approaches in the treatment of Barrett’s esophagus.
|Ablation by argon plasma coagulation is more effective than photodynamic therapy|
|Digestive Diseases and Sciences|
Searches were conducted in the databases PUBMED, EMBASE, and Cochrane Library.
The researchers identified 13 randomized clinical trials that fulfilled the inclusion criteria.
The team noted that neither the pharmacological nor surgical therapies currently available for reflux appear to achieve complete regression of Barrett’s esophagus and the elimination of the cancer risk associated with it.
The researchers found that, in contrast, endoscopic ablative techniques are capable of achieving endoscopic and histological reversal of Barrett’s esophagus.
Ablation by argon plasma coagulation appears to be more effective than treatment with photodynamic therapy.
There was no statistically significant difference between argon plasma coagulation and multipolar electrocoagulation in terms of the efficacy to achieve regression of Barrett’s esophagus.
Dr Li’s team concluded, “There have been only a limited number of randomized controlled trials that compare treatments for Barrett’s esophagus.
The pharmacological therapy, antireflux surgery, and endoscopic ablative techniques are promising in terms of treating Barrett’s esophagus.”
“However, the studies carried out to date have had no adequate power to assess the effect of treatment on reducing and preventing progression to adenocarcinoma.”