Article Abstract

Role of radiofrequency ablation in Barrett’s esophagus

Authors: Martin Riegler, Gerd Jomrich, Sebastian F. Schoppmann

Abstract

Barrett’s esophagus (BE) with and without dysplasia results from gastroesophageal reflux and harbors and increased cancer risk. Radiofrequency ablation (RFA) represents a novel tool for effective BE treatment and cancer prevention. This web-based research examined the role of RFA for treatment of BE ± dysplasia and early cancer. RFA ± endoscopic resection prevents cancer and cancer progression in those with dysplastic BE and early cancer, respectively. High cancer risk positive individuals with nondysplastic BE should be offered RFA within controlled trials. Post RFA management includes proton pump inhibitor (PPI) therapy. The efficacy anti-reflux surgery (+ hiatal repair) for cancer prevention prior, during or after RFA (± endoscopic resection) awaits further proof and should therefore only be offered within controlled trials. Accurate follow-up endoscopies are required for adequate management monitoring. Regular consumption of concentrated sugar containing food and beverages associates with an increased risk for gastroesophageal reflux disease (GERD), BE and cancer. RFA ± endoscopic resection is recommended for treatment of dysplastic BE and early cancer. Within controlled trials RFA should be offered to persons with cancer risk positive BE without dysplasia. The efficacy of anti-reflux surgery (prior, during, after RFA) for cancer prevention awaits further proof and should be offered within controlled trials. A low carb diet should be included into the management of GERD and BE.