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Cryotherapy less painful than RFA for Barrett’s esophagus
Patients with Barrett’s esophagus who underwent liquid nitrogen spray cryotherapy experienced less postprocedural pain than those treated with radiofrequency ablation, according to a new study published in the Journal of Clinical Gastroenterology.
Arvind Trindade, MD, of Long Island Jewish Medical Center at Northwell Health, and colleagues wrote that while both procedures are common treatments for Barrett’s esophagus (BE), there had been no data comparing postprocedural pain.
“While individual data exists on the efficacy of both modalities, there is limited data comparing the side effect profiles of the two ablation methods,” Trindade and George Smallfield, MD, of Virginia Commonwealth University Health said in a press release. “Our results will help physicians explain to their patients what to expect after the procedure.”
The investigators conducted a multicenter prospective study of 94 patients with BE treated with either liquid nitrogen spray cryotherapy (LNC) or radiofrequency ablation (RFA). They compared pain intensity scores, and the presence of dysphagia immediately before and after treatment, 48 hours after treatment and at 3 weeks after treatment.
Thirty-five patients underwent LNC and 59 underwent one of two kinds of RFA treatment: focal RFA (RFA-F; n = 36) and circumferential RFA (RFA-C; n = 23).
Patients in the LNC group reported a lower average numeric pain score (0.41) immediately after treatment than the RFA-F group (1.18; P = .026) and the RFA-C group 1.38; P = .01). The differences lasted through the 48-hour post-treatment period (LNC = 0.76 vs. RFA-F = 1.77; P = 0.013; RFA-C 1.73; P = .018).
Patients who received RFA had at least a five times greater chance for pain immediately after treatment than those who received LNC (OR = 5.26; 95% CI, 1.85–14.29), and at 48 hours after treatment (OR = 5.56; 95% CI, 2.27–14.29).
There was no difference in dysphagia in either group at any time. – by Alex Young
Disclosures: The authors reported no relevant financial disclosures.