Argon plasma coagulation versus endoscopic resection for the treatment of gastric adenomas: A systematic review and meta-analysis

Abstract

Background: Endoscopic resection (ER) is regarded as the treatment of choice for gastric adenoma. Argon plasma coagulation (APC) is also widely used, but its efficacy and safety have not been fully established. We performed a systematic review and meta-analysis to assess the efficacy and safety of APC compared with ER in treating gastric adenoma.

Methods: PubMed, EMBASE, and the Cochrane Library were searched up to April 2024. All studies that evaluated the clinical outcomes of APC or ER for treating gastric adenomas were included. The primary outcome was the local recurrence rates of APC versus ER. Secondary outcomes included procedure time, length of hospital stay, and complications.

Results: A total of seven studies were included, of which four were retrospective studies that compared the outcomes of APC and ER, and three were retrospective single-arm studies that reported only outcomes of APC. APC was associated with a higher local recurrence rate in treating gastric adenoma than ER [risk ratio (RR) 4.378, 95% CI 1.995–9.607] but involved shorter procedure times (MD -45.228, 95% CI -49.436 to -41.021), shorter hospital stays (MD -2.684, 95% CI -2.932 to -2.437), and fewer complications (RR 0.329, 95% CI 0.124–0.869).

Conclusions: APC results in more local recurrence but involved a lower risk of complications than ER. APC may be considered an alternative to ER in treating gastric adenomas.