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Due to its less
postprocedural pain-causing tendency as compared to radiofrequency ablation,
the liquid nitrogen spray cryotherapy can be a better procedure for the
eradication of dysplastic Barrett’s oesophagus.
As compared to radiofrequency ablation (RFA), Liquid nitrogen spray cryotherapy (LNC) associates with less postprocedural pain while eradication of dysplastic Barrett’s esophagus, evident from the findings a multicenter prospective study published in the Journal of Clinical Gastroenterology. Both therapies are most commonly used regimens for dysplastic Barrett’s esophagus (BE) eradication. However, no evidence was present before regarding the postprocedural pain after these therapies.
Patients of 18 years of age or older, documented (BE) with intramucosal
cancer/low-grade dysplasia (LGD)/high-grade dysplasia and received LNC or RFA
ablative endotherapy were recruited for the analysis. Presence of dysphagia and
pain intensity scores were immediately evaluated before and following the
treatment, two days and three weeks postoperatively using Numeric Pain Scale
(NPS) and Pain Quality Assessment Scale (PQAS).
A total of 94 patients selected, out of which 59 went through RFA, and 35 went
through LNC. Immediately after the treatment, RFA groups exhibited higher
Numeric Pain Scale score as compared to the LNC group, which persisted till two
days afterwards. No group difference was noticed in the dysphagia after the
surgery at any time point. The odds of pain after LNC were at least five times
lower than after RFA. All these findings help physicians to know regarding
expected symptoms after ablative endotherapy.
Journal of Clinical Gastroenterology
Liquid Nitrogen Spray Cryotherapy is Associated With Less Postprocedural Pain Than Radiofrequency Ablation in Barrett's Esophagus: A Multicenter Prospective Study.
Sanjeev Solomon et al.
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