TY - JOUR
T1 - Initial multicenter experience with nitrous oxide cryoballoon for treatment of flat duodenal adenomas (with video)
AU - Dbouk, Mohamad
AU - Brewer Guiterrez, Olaya
AU - Trindade, Arvind J.
AU - Diehl, David L.
AU - Kwon, Richard S.
AU - Thosani, Nirav C.
AU - Khara, Harshit S.
AU - Benias, Petros C.
AU - Kerdsirichairat, Tossapol
AU - Canto, Marcia Irene
N1 - Funding Information:
DISCLOSURE: Dr Canto has received research grants from Pentax Medical and Endogastric Solutions, has ownership interest (royalties) in UpToDate, and has served as a consultant for Exigo Management Consultants and Exact Science. Dr Trindade has received a research grant from Ninepoint Medical and has served as a consultant for Pentax Medical and Olympus. Dr Diehl has served as a consultant for Pentax Medical, Olympus, Cook Medical, Boston Scientific, and Medtronic. Dr Thosani is consultant for Boston Scientific Corporation, Medtronic, and Pentax America; receives royalties from UpToDate; and is a speaker for Abbvie. Dr Khara has received a research grant from and has served as a consultant for Pentax Medical. Dr Benias is associated with Olympus, Fujinon, Medtronic, and Apollo Endosurgery. All other authors disclosed no financial relationships.
Publisher Copyright:
© 2021 American Society for Gastrointestinal Endoscopy
PY - 2021/1
Y1 - 2021/1
N2 - 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.
AB - 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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U2 - 10.1016/j.gie.2020.05.048
DO - 10.1016/j.gie.2020.05.048
M3 - Article
C2 - 32511958
AN - SCOPUS:85090138930
SN - 0016-5107
VL - 93
SP - 240
EP - 246
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 1
ER -