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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(02): E211-E217
DOI: 10.1055/a-2231-7328
Original article

Endoscopic spray cryotherapy for dysphagia palliation in esophageal cancer: Systematic review and meta-analysis

Harishankar Gopakumar 
1   Division of Gastroenterology and Hepatology, University of Illinois Chicago College of Medicine at Peoria, Peoria, United States (Ringgold ID: RIN17120)
,
Hamza Khan
2   Mund-Lagowski Department of Chemistry and Biochemistry, Bradley University, Peoria, United States (Ringgold ID: RIN6496)
,
Neil Sharma
3   Gastroenterology, Parkview Health, Fort Wayne, United States (Ringgold ID: RIN3395)
,
Srinivas Reddy Puli
1   Division of Gastroenterology and Hepatology, University of Illinois Chicago College of Medicine at Peoria, Peoria, United States (Ringgold ID: RIN17120)
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Abstract

Background and study aims Endoscopically delivered liquid nitrogen spray cryotherapy is reported to be a safe and possibly more effective strategy for dysphagia palliation in patients with advanced esophageal cancer. This systematic review and meta-analysis aimed to pool all available data to evaluate the impact of this treatment modality.

Methods Electronic databases (PubMed, Embase, and Cochrane Library) from January 2005 through June 2023 were searched for studies evaluating endoscopically delivered liquid nitrogen spray cryotherapy for dysphagia palliation in patients with advanced esophageal cancer. Pooled proportions were calculated using random-effects (DerSimonian-Laird) model.

Results From an initial 895 studies, data were extracted and analyzed from five studies comprising a total of 230 patients that met inclusion criteria. In this pooled analysis, dysphagia improved or did not deteriorate in 81.40% of patients (95% confidence interval [CI] 73.75–87.99). Significant improvement in dysphagia was reported by 55.19% of patients (95% CI 29.62–79.37). An alternate method of dysphagia palliation despite spray cryotherapy was required in 18.78% of patients (95% CI 8.09–32.63) with 10.56% (95% CI 2.53–23.18) requiring esophageal stents. The weighted mean number of spray cryotherapy sessions per patient was 3.37 (95% CI 2.55–4.18). The pooled major adverse event rate was 3.26% (95% CI 0.15–10.14).

Conclusions Endoscopic liquid nitrogen spray cryotherapy can effectively and safely treat dysphagia in esophageal cancer. It can be considered an option for dysphagia palliation in centers with expertise and equipment.

Keywords

Barrett's and adenocarcinoma - Malignant strictures - RFA and ablative methods - Endoscopic ultrasonography - Esophageal cancer

Supplementary Material



Publication History

Received: 23 August 2023

Accepted after revision: 11 December 2023

Accepted Manuscript online:
18 December 2023

Article published online:
12 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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