Radiofrequency Ablation of Barrett's Esophagus: Short-Term Results

Eldaif, Shady M.; Lee, Edward; Singh, Kimberly A.; Force, Seth D.; Miller, Daniel

doi:10.1016/j.athoracsur.2008.11.043

Cited by 23 publications

(13 citation statements)

References 25 publications

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“…There were no serious adverse event and strictures occurred in 1.1% of procedures. Similar safety and efficacy results for step-wise RFA for BE containing ND-BE have been reported from a number of other prospective singlecenter studies [85,86]. Further, all studies which have studied RFA for BE containing with dysplasia have CR-IM as a primary endpoint, with similar CR-IM outcomes as seen in the ND-BE patient trials.…”

Section: Pathologic and Molecular Features Of Barrett's Esophagussupporting

confidence: 73%

The Case for Endoscopic Treatment of Non-dysplastic and Low-Grade Dysplastic Barrett’s Esophagus

et al. 2010

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Non-dysplastic mucosa (ND-) in Barrett's esophagus (BE) shows clonal molecular aberrations, loss of cell cycle control, and other features of "neoplasia." These changes occur prior to morphologic expression of neoplasia (dysplasia). Morphologic evaluation of dysplasia is fraught with error, and, as a result, often leads to false-negative and false-positive diagnoses. Early "crypt dysplasia" is difficult to detect, and is often missed in routine biopsy specimens. Some studies show substantial progression rates of low-grade dysplasia (LGD), and crypt dysplasia, to esophageal adenocarcinoma (EAC). Dysplasia, even when fully developed, may, in certain circumstances, be difficult to differentiate from non-dysplastic (regenerating) BE. Radiofrequency ablation (RFA) is a safe and effective method for removing mucosa at risk of cancer. Given the difficulties of dysplasia assessment in mucosal biopsies, and the molecular characteristics of ND-BE, this technique should be considered for treatment of all BE patients, including those with ND or LGD. Post-ablation neo-squamous epithelium reveals no molecular abnormalities, and is biologically stable. Given that prospective randomized controlled trials of ablative therapy for ND-BE aiming at reducing EAC incidence and mortality are unlikely to be completed in the near future, endoscopic ablation is a valid management option. The success of RFA in achieving safe, uniform, reliable, and predictable elimination of BE allows surgeons to combine fundoplication with RFA. Currently, there is no type of treatment for dysplastic or non-dysplastic BE that achieves a complete response in 100% of patients, eliminates all risk of developing cancer, results in zero adverse events, is less expensive in terms of absolute costs than surveillance, is durable for 20+ years, or eliminates the need for surveillance. Regardless, RFA shows established safety, efficacy, durability, and cost-effective profiles that should be considered in the management of patients with non-dysplastic or low-grade dysplastic BE.

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Section: Pathologic and Molecular Features Of Barrett's Esophagussupporting

confidence: 73%

The Case for Endoscopic Treatment of Non-dysplastic and Low-Grade Dysplastic Barrett’s Esophagus

et al. 2010

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“…Immediate postprocedure adverse events such as postprocedure chest pain, transient dysphagia, odynophagia, mucosal laceration, and nausea have been described. [1][2][3][4][5][6][7][8] Stricture formation has also been reported. 5,8,9 Esophageal perforation, although infrequently seen, has also been associated with RFA.…”

Section: Discussionmentioning

confidence: 91%

“…3 Although limited, current data suggest that the outcomes of endoscopy and surgery for the management of DPDS are suboptimal. [4][5][6] In a recent study of 31 patients who underwent endoscopic transmural drainage of PFCs in the setting of DPDS, there was 42% recurrence of PFCs on long-term follow-up. 6 A randomized trial from Europe that compared permanent and temporary stents for transmural drainage of PFCs found that stent removal was associated with higher rates of PFC recurrence.…”

Section: Shyam Varadarajulu MD C Mel Wilcox Mdmentioning

confidence: 99%

A case of mediastinitis after radiofrequency ablation for Barrett's esophagus

Yoon

Rivera

Antignano

et al. 2011

Gastrointestinal Endoscopy

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“…[27][28][29] This translates to less than 0.7% of patients having subsquamous glandular mucosa post-RFA. [28][29][30][31][32][33][34][35][36][37][38][39]…”

Section: Photo Dynamic Therapy Ablation and Multipolar Electro Coagulmentioning

confidence: 99%

Barrett's esophagus: endoscopic treatments II

Greenwald

Lightdale

Abrams

et al. 2011

Annals of the New York Academy of Sciences

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The following on endoscopic treatments of Barrett's esophagus includes commentaries on animal experiments on cryotherapy; indications for cryotherapy, choice of dosimetry, number of sessions, and role in Barrett's esophagus and adenocarcinoma; recent technical developments of RFA technology and long-term effects; the comparative effects of diverse ablation procedures and the rate of recurrence following treatment; and the indications for treatment of dysplasia and the role of radiofrequency ablation.

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Radiofrequency Ablation of Barrett's Esophagus: Short-Term Results

Cited by 23 publications

References 25 publications

The Case for Endoscopic Treatment of Non-dysplastic and Low-Grade Dysplastic Barrett’s Esophagus

The Case for Endoscopic Treatment of Non-dysplastic and Low-Grade Dysplastic Barrett’s Esophagus

A case of mediastinitis after radiofrequency ablation for Barrett's esophagus

Barrett's esophagus: endoscopic treatments II

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