Radiofrequency ablation is effective for the treatment of high-grade dysplasia in Barrett's esophagus after failed photodynamic therapy.

Abstract

Endoscopic radiofrequency ablation (RFA) is an effective treatment for high-grade dysplasia in Barrett's esophagus in ablation-naïve patients, but no studies have evaluated its use in patients in whom ablative therapy has previously failed. We describe 14 patients with residual high-grade dysplasia following aminolevulinic acid or Photofrin (porfimer sodium) photodynamic therapy (PDT). An overall complete reversal of dysplasia was achieved in 86 % with a combination of RFA and rescue endoscopic mucosal resection. The median total follow-up is 19 months. The rate of strictures was 7 % (1/14) and there was a low rate of buried glands (0.5 % follow-up biopsies). These data suggest RFA is both safe and effective for eradication of high-grade dysplasia in patients in whom PDT has failed.

• Authors: J M Dunn, M R Banks, D Oukrif, G D Mackenzie, S Thorpe, M Rodriguez-Justo, A Winstanley, S G Bown, M R Novelli, L B Lovat
• Journal: Endoscopy (Endoscopy) Vol. 43 Issue 7 Pg. 627-30 (Jul 2011) ISSN: 1438-8812 [Electronic] Germany
• PMID: 21717379 (Publication Type: Journal Article)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Topics

• Aged
• Aged, 80 and over
• Barrett Esophagus (drug therapy, pathology, surgery)
• Catheter Ablation
• Esophagoscopy
• Female
• Humans
• Male
• Middle Aged
• Photochemotherapy
• Prospective Studies
• Treatment Failure
• Treatment Outcome