Endoscopic treatments for Barrett's esophagus: a systematic review of safety and effectiveness compared to esophagectomy

Menon, Devidas; Stafinski, Tania; Wu, Heng; Lau, Darren; Wong, Clarence

doi:10.1186/1471-230X-10-111

Table 6 Summary of adverse events post-endoscopic treatments

From: Endoscopic treatments for Barrett's esophagus: a systematic review of safety and effectiveness compared to esophagectomy

	Adverse event rates post- endoscopic treatments (No. of patients who suffered adverse events/No. of patients who received treatments)
Study	Dysphagia	Photosen.*	Stricture	Perfor.*	Odynoph.*	Bleed.*
*PDT*
ALA 15 mg/kg	15.4% (2/13)	13.6% (3/22) 0-23.1%†	0% (0/22)	0% (0/22)	0% (0/22)	0% (0/22)
ALA 30 mg/kg	0% (0/106)	5.7% (6/106) 0-14.7%†	0% (0/106)	0% (0/106)	0.9% (1/106) 0-2.9%†	0%⁽⁴⁾ (0/90)
ALA 40 mg/kg	0% (0/22)	0% (0/22)	0% (0/22)	0% (0/22)	0% (0/22)	0% (0/22)
ALA ⁽¹⁾ 60 mg/kg	2.7% (4/148) 0-40.0%†	4.3% (6/140) 0-75.0%†	1.4% (2/148) 0-12.5%†	0% (0/148)	16.2% (24/148) 0-92.3%†	0.9%⁽⁴⁾ (1/115) 0-7.7%†
HpD 1.5 mg/kg	0% (0/59)	40.0% (2/5)	0% (0/59)	0% (0/59)	0% (0/5)	0% (0/59)
mTHPC 0.15 mg/kg	-**	-**	-**	-**	-**	-**
Porfimer sodium(2 mg/kg)	6.6% (26/394) 0-18.8%†	26.4% (104/394) 0-68.8%†	18.5% 73/394 0-37.5%†	0% (0/394)	0% (0/394)	0% (0/394)
*Other endoscopic treatments*
APC	3.8% (27/719) 0-100%†	0% (0/719)	2.9% (21/719) 0-23.1%†	0.3% (2/719) 0-3.4%†	11.8% (85/719) 0-94.1%†	0.4%⁽²⁾ (3/719) 0-3.9%†
Cryoablation	9.1% (1/11)	0% (0/11)	0% (0/11)	0% (0/11)	0% (0/11)	0% (0/11)
Combined EMR & PDT	0% (0/6)	0% (0/6)	0% (0/6)	0% (0/6)	0% (0/6)	0% (0/6)
Thermocoagualtion	0% (0/13)	0% (0/13)	0% (0/13)	0% (0/13)	0% (0/13)	0% (0/13)
EMR	0% (0/32)	0% (0/32)	0% (0/32)	0% (0/32)	0% (0/32)	9.4% (3/32) 0-25.0%†
Laser ablation	0% (0/68)	0% (0/68)	4.4% (3/68) 0-12.5%†	1.5% (1/68) 0-4.8%†	0% (0/68)	1.5%⁽⁵⁾ (1/68) 0-4.8%†
MPEC	19.4% (18/93) 0-40.7%†	0% (0/93)	1.1% (1/93) 0-3.7%†	0% (0/93)	16.1% (15/93) 0-40.7%†	1.1% (1/93) 0-10.0%†
RFA	1.4% (8/574) 0-23.1%†	0% (0/574)	1.9% (11/574) 0-6.1%†	0% (0/574)	0.5% (3/574) 0-23.1%†	0.5% (3/574) 0-1.6%†

Notes:(1) 1 patient suffered cardiac arrhythmia resulting in sudden death [13]. (2) 2 patients required blood transfusions. (3) ALA (aminolevulinic acid), APC (argon plasma coagulation), EMR (endoscopic mucosal resection), HpD (hematoporphyrin derivative), MPEC (multipolar electrocoagulation), mTHPC (meta-tetrahydroxyphenylchlorin), PDT (photodynamic therapy), RFA (radiofrequency ablation) (4) 1 patient required blood transfusion, but it cannot be definitely attributed to the 30 mg/kg treatment or the 60 mg/kg ALA treatment. (5) 1 patient required blood transfusion. (6) * Photosen. (photosensitivity), Perfor. (perforation), Odynoph. (odynophagia), Bleed. (bleeding), ** - (pooled total not available), † Ranges of the adverse event rates post-endoscopic treatments for the included studies

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