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Endoscopic circumferential ablation promising for Barrett's esophagus with high-grade dysplasia
Date:7/31/2008

circumferential balloon-based ablation using radiofrequency energy for the treatment of BE HGD at 16 U.S. academic and community institutions," said study lead author Robert A. Ganz, MD, FASGE, Minnesota Gastroenterology, Minneapolis. "Results were promising, showing that 90.2 percent of patients were free of high-grade dysplasia at an average of one-year follow-up and avoided many of the adverse events associated with other modalities currently used with this disease."

Patients who have BE with HGD have historically been referred for surgical removal of the esophagus. However, over the last several years alternative therapies for these patients have been pursued given the risks of surgery. These therapies include endoscopic mucosal resection (EMR), endoscopic ablation by using photodynamic therapy (PDT), and a myriad of other thermal and nonthermal modalities. Each therapeutic strategy has specific limitations, such as technical complexity of the procedure itself, stricture formation leaving behind buried Barrett's esophagus, photosensitivity, and stricture formation.

The primary benefit shared by the endoscopic techniques is esophageal preservation, whereas esophagectomy has merit because of resection of the entire organ, which allows for complete histologic assessment and removal of all the at-risk tissue. Circumferential ablation with a balloon-based radiofrequency device is a more recently available endoscopic ablation technique for BE HGD. This procedure burns away the abnormal cells with radiofrequency energy.

Patients and Methods

A total of 142 patients (median age 66 years) at 16 academic and community centers in the U.S. were enrolled in the registry from September 2004 to March 2007. Patients had histologic evidence of IM that contained HGD confirmed by at least two expert pathologists. A prior EMR was permitted provided that residual HGD remained in the BE region for ablation.

The endoscopic circ
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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