Spray Cryotherapy Esophageal Consortium Consensus Recommendations for Liquid Nitrogen Spray Cryotherapy in Barrett's Esophagus and Esophageal Cancer Using a Modified Delphi Process
Year: 2025
Type: article
Abstract: INTRODUCTION: The study aimed to develop consensus recommendations for the safe and appropriate use of liquid nitrogen spray cryotherapy in Barrett's esophagus and esophageal cancer. METHODS: Statements were initially formulated and grouped into categories of indications, training, preprocedure, intraprocedure, and postprocedure recommendations, frequency/timing of repeat procedures, and contraindications. Two investigators assessed the strength of the evidence for each statement using Grading of Recommendations Assessment, Development, and Evaluation methodology. Nineteen experts were invited to participate in a modified Delphi process. For statements that received >80% agreement, minor iterative edits were performed until there was unanimous consensus. If a threshold of 80% agreement was not reached, the statement was modified based on feedback and included in the next Delphi round. Statements were rejected if no consensus was reached after 3 rounds. RESULTS: After 3 Delphi rounds, 41 of 42 statements were accepted either in their original version (n = 11) or after modification based on expert input (n = 30). DISCUSSION: Through a modified Delphi process, we developed expert and evidence-based consensus recommendations to guide safe and appropriate use of liquid nitrogen spray cryotherapy in Barrett's esophagus and esophageal cancer.
Authors: Tilak Shah, Zaid Ansari, Akram Ahmad, Walter Coyle, Bruce B. Greenwald, Toufic Kachaamy, Shivangi Kothari, Neil Sharma, George Smallfield, Shyam Thakkar, Franklin Tsai, Han Zhang, Shai Friedland, Norio Fukami, Shaffer Mok, Alireza Sedarat, Michael Smith, John Vargo, Pankaj Vashi, Field Willingham, Alla Turshudzhyan, Vivek Kaul
Institutions: Cleveland Clinic, Cleveland Clinic Florida, Scripps Clinic, University of Maryland, Baltimore, City of Hope, University of Rochester Medicine, Banner MD Anderson Cancer Center, West Virginia University, West Virginia University Hospitals, Stanford Medicine, Mayo Clinic, Mayo Clinic in Arizona, Mayo Clinic Hospital, Moffitt Cancer Center, University of California, Los Angeles, UCLA Medical Center, Los Angeles Medical Center, Mount Sinai Hospital, Mount Sinai Medical Center, Emory University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,390
OpenAlex ID: W4413683545