Radiofrequency ablation of Barrett's esophagus

BACKGROUND: Barrett's esophagus (BE) is an important risk factor for esophageal carcinoma and its incidence is likely rising. Amongst the various available endoscopic ablative therapies, radiofrequency ablation (RFA) is a very promising new one. METHODS: We performed a comprehensive review of the literature on the treatment of BE using RFA. We searched for published articles on Pubmed and also reviewed the abstracts from the major gastroenterological society meetings of 2007 and 2008. RESULTS: RFA is an effective option in treating BE, especially when dysplastic changes are present, achieving high eradication rates with minimal complications. Prior control of intra-esophageal pH by either pharmacologic therapy or fundoplication is important in maximizing efficacy and preventing relapse. CONCLUSIONS: RFA is a very well tolerated therapy for non-dysplastic and dysplastic BE and will likely become a first-line treatment. More data, however, will be needed to compare the various existing modalities of endoscopic ablative and resection therapies for BE.