Radiofrequency ablation in the management of Barrett’s esophagus – preliminary own experience

Wojciech P. Dąbrowski; Andrzej B. Szczepanik; Andrzej Misiak; Konrad Pielaciński

doi:10.5114/wiitm.2011.32807

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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2/2013
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abstract:

Original paper

Radiofrequency ablation in the management of Barrett’s esophagus – preliminary own experience

Wojciech P. Dąbrowski

,

Andrzej B. Szczepanik

,

Andrzej Misiak

,

Konrad Pielaciński

Videosurgery Miniinv 2013; 8 (2): 107-111

DOI: https://doi.org/10.5114/wiitm.2011.32807

Online publish date: 2013/01/16

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Introduction: Barrett’s esophagus develops as a result of chronic injury of esophagus epithelium from gastroesophageal reflux disease. It is defined when metaplastic columnar epithelium replaces the stratified squamous epithelium which normally lies in the distal esophagus. The condition represents a risk factor for esophageal adenocarcinoma. The aim of the radiofrequency ablation (RFA) method is to destroy metaplastic epithelium with radiofrequency electric current and to stimulate reappearance of the flat multilayer epithelium in the distal esophagus.

Aim: To evaluate the efficiency and safety of the RFA technique, newly introduced in Poland, in the management of Barrett's esophagus.

Material and methods: Twelve patients were treated with the RFA method. Patients with Barrett's esophagus confirmed in the histopathological report were qualified for treatment. Two RFA techniques were applied using a BARRX^® device: circular based on the balloon HALO360 system or focal based on the HALO90 system mounted to the endoscopic ending. The procedures were performed at 2-month intervals. The macroscopic and microscopic effects of RFA therapy, the patients’ treatment tolerance as well as potential complications were evaluated.

Results: In the group of 12 patients subjected to RFA therapy, 10 completed the therapeutic cycle. A total of 37 procedures were performed: 5 HALO360 and 32 HALO90. In all patients eradication of the abnormal metaplastic esophageal epithelium was achieved, as confirmed in both endoscopic and histopathological evaluation. In 2 patients with ongoing therapy progressive eradication of metaplastic epithelium was observed. No significant RFA-related complications were reported.

Conclusions: Based on our preliminary results we consider this method to be promising, free of significant complications and well tolerated by patients. In most patients it results in successful eradication of metaplastic epithelium in the distal esophagus.

keywords:

Radiofrequency ablation in the management of Barrett’s esophagus – preliminary own experience

Wojciech P. Dąbrowski , Andrzej B. Szczepanik , Andrzej Misiak , Konrad Pielaciński

Barrett’s esophagus, metaplasia, radiofrequency ablation

Wojciech P. Dąbrowski

,

Andrzej B. Szczepanik

,

Andrzej Misiak

,

Konrad Pielaciński