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Benefit of radiofrequency ablation after widespread endoscopic resection of neoplastic Barrett’s esophagus in daily practice

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Ελληνική Γαστροεντερολογική Εταιρία   

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Annals of Gastroenterology   

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Benefit of radiofrequency ablation after widespread endoscopic resection of neoplastic Barrett’s esophagus in daily practice (EN)
Pesenti, Christian
Ratone, Jean Phillipe
Giovannini, Marc
Caillol, Fabrice
Poizat, Flora
Godat, Sebastien
Marx, Mariola
Schoepfer, Alain
Bories, Erwan
Autret, Aurélie
Robert, Maxime
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
2022-01-10
Background High-grade dysplasia (HGD) and intramucosal carcinoma (IMC) in Barrett’s esophagus (BE) are now well-established indications for endoscopic resection (ER).&nbsp;Radiofrequency ablation (RFA) can be combined with ER in case of flat or long-segment BE ablation. We report here our experience of complementary RFA after widespread ER of neoplastic BE in daily practice. Method We retrospectively reviewed data of 89 patients, treated between 2006 and 2013 by ER alone (group 1) or by ER combined with RFA (group 2). Results Fifty-five patients in group 1 (7F/48M, mean age 68 years) underwent widespread ER with eradication of residual non-dysplastic BE. Complete eradication of HGD/IMC and intestinal metaplasia (IM) was achieved in 32/32 (100%) and 48/55 (87.3%) patients,&nbsp;respectively. Thirty-four patients in group 2 (3F/31M, mean age 67 years) had a multimodal treatment strategy, with widespread ER followed by RFA. Mean Prague classification of BE in this group was significantly longer (C4.4M6.6 vs. C2.7M4.5, P<0.001). Complete eradication of HGD/IMC and non-dysplastic BE was confirmed in 26/27 (96.3%) and 20/34 (58.8%) patients, respectively. There was no significant difference between groups concerning adverse events (16.4% vs. 23.5%, P=0.58) or recurrence rate of HGD/IMC (9.1% vs. 14.7%, P=0.42). The mismatch rate between preoperative and final histological diagnosis was high in both groups, at 45.5% and 26.5%. Conclusions A combination of ER and RFA can treat significantly longer neoplastic BE than ER alone, with the same efficiency and safety. Widespread ER, in contrast, is the only method of obtaining a reliable histological diagnosis. Keywords Barrett’s esophagus, high-grade dysplasia, esophageal cancer, endoscopic resection, radiofrequency ablation Ann Gastroenterol 2022; 35 (1): 34-41 (EN)
Αγγλική γλώσσα
Hellenic Society of Gastroenterology (EN)
1792-7463
1108-7471
Annals of Gastroenterology; Volume 35, No 1 (2022); 34 (EN)
Copyright (c) 2022 Annals of Gastroenterology (EN)
Ελληνική Γαστροεντερολογική Εταιρία
Annals of Gastroenterology
Original Articles



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