Abstract | BACKGROUND AND AIMS: EMR is the preferred endoscopic therapy for duodenal adenomas ( DAs) but is associated with an overall adverse event rate of 26%. Cryotherapy using a Cryoballoon Focal Ablation System (CbFAS) can safely and effectively eradicate esophageal intestinal metaplasia. We report our first experience with cryoballoon ablation for treatment of flat DAs. METHODS: This was an American, multicenter, retrospective study involving 5 centers. DAs (Paris 0-IIa and 0-IIb) were treated with nitrous oxide for 5 to 12 seconds using CbFAS. Follow-up EGD was performed at 3 to 12 months. RESULTS: Seventeen DAs (mean size, 22.7 ± 14.3 mm; 12 tubular, 5 tubulovillous) from 13 patients (mean age, 66.5 ± 9.99 years; 61.5% males) were included in the study. Thirteen of 17 DAs (76.5%) had failed previous treatment, and 4 of 17 (23.5%) were treatment naÏve. All procedures were technically successful and achieved a >50% decrease in size after cryoballoon ablation There was no increase in size or progression of disease for any lesions. Overall, treatment was completed in 15 of 17 patients, and recurrence-free survival was achieved in 12 of 17 (71%) after a median follow-up of 15.5 months (interquartile range [IQR], 6.8-19.4). The median cryoablation time per polyp was 4 minutes (IQR, 1-7.5 minutes), and the median total procedure time was 25 minutes (IQR, 22-30.5 minutes). There were no intra- or postprocedural adverse events. CONCLUSIONS:
Nitrous oxide cryoballoon ablation of nonpolypoid DAs is feasible, with promising safety and efficacy.
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Authors | Mohamad Dbouk, Olaya Brewer Guiterrez, Arvind J Trindade, David L Diehl, Richard S Kwon, Nirav C Thosani, Harshit S Khara, Petros C Benias, Tossapol Kerdsirichairat, Marcia Irene Canto |
Journal | Gastrointestinal endoscopy
(Gastrointest Endosc)
Vol. 93
Issue 1
Pg. 240-246
(01 2021)
ISSN: 1097-6779 [Electronic] United States |
PMID | 32511958
(Publication Type: Journal Article, Multicenter Study, Video-Audio Media)
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Copyright | Copyright © 2021 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adenoma
(surgery)
- Aged
- Atrial Fibrillation
- Catheter Ablation
- Cryosurgery
- Female
- Humans
- Male
- Middle Aged
- Nitrous Oxide
- Retrospective Studies
- Treatment Outcome
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