Evidence map›Paper›PMID 26135648›Full record

ArticleEndoscopy international open2015

Cryospray ablation using pressurized CO2 for ablation of Barrett's esophagus with early neoplasia: early termination of a prospective series.

Romy E Verbeek, Frank P Vleggaar, Fiebo J Ten Kate, Jantine W P M van Baal, Peter D Siersema

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Endoscopy international open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Cryotherapy in gastrointestinal endoscopy.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2017
    Article
  6. Barrett's esophagus: diagnosis and management.Gastrointestinal endoscopy · 2017
    Review
  7. Role of endoscopy in early oesophageal cancer.Nature reviews. Gastroenterology & hepatology · 2016
    Review
  8. Review
  9. The role of ablation in the treatment of dysplastic Barrett's esophagus.Therapeutic advances in gastrointestinal endoscopy
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Romy E VerbeekDepartment of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
Frank P VleggaarDepartment of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
Fiebo J Ten KateDepartment of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
Jantine W P M van BaalDepartment of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
Peter D SiersemaDepartment of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
University Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCryotherapy is a relatively novel ablation modality for the endoscopic ablation of Barrett's esophagus (BE). Data on the use of pressurized carbon dioxide (CO2) gas for cryoablation are scarce. STUDY

aimTo determine the efficacy and safety of cryospray ablation using pressurized CO2 gas in the treatment of BE with early neoplasia.

methodsIn this prospective single center case series, we aimed to include 30 patients with BE and early neoplasia. Nodular neoplastic lesions were treated with endoscopic mucosal resection (EMR). Residual BE mucosa was treated with cryospray ablation every 4 weeks until the complete BE segment was eliminated or up to seven treatment sessions. If no reduction of the BE segment was observed after two subsequent treatment sessions, cryoablation was terminated. Patients were contacted at days 1 and 4 post-treatment to evaluate the level of discomfort. Endoscopic and histologic follow-up evaluations were performed up to 24 months post-treatment.

resultsAfter the inclusion of 10 patients, insufficient effect of cryoablation was observed, resulting in early termination of the study. In total, seven patients with intramucosal carcinoma (IMC) and three with high grade dysplasia (HGD) were included. Prior EMR was performed in nine patients. A median of 2.5 (IQR 2.0 - 4.0) cryoablation sessions were performed. At 6 months of follow-up, complete eradication of intestinal metaplasia was observed in 11 % (1 /9; one patient died, not treatment or disease related) of the patients and complete eradication of dysplasia in 44 % (4 /9). In three patients, HGD or IMC was detected during follow-up, and was endoscopically treated. Apart from a gastric perforation as a result of gastric distension caused by CO2 gas during the first treatment, cryospray treatments were well tolerated.

conclusionAfter a short learning curve, cryoablation using CO2 gas was found to be a safe and well tolerated treatment modality. However, in our experience, the efficacy of CO2 cryoablation combined with EMR for nodular lesions is disappointing for the treatment of BE associated neoplasia.

Identifiers

PMID26135648
PMCPMC4477021
OpenAlexW1983327892

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.