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KMID : 1038120210540050669
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Clinical Endoscopy
2021 Volume.54 No. 5 p.669 ~ p.677
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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
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Hirsch Bruno Salomao
Ribeiro Igor Braga
Funari Mateus Pereira
De Moura Diogo Turiani Hourneaux
Matuguma Sergio Eiji
Sanchez-Luna Sergio A.
Mancini Fabio Catache
de Oliveira Guilherme Henrique Peixoto
Bernardo Wanderley Marques
De Moura Eduardo Guimaraes Hourneaux
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Abstract
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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.
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KEYWORD
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Argon plasma coagulation, Endoscopic band ligation, Endoscopy, Gastric antral vascular ectasia
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