RADIOFREQUENCY ABLATION REFLUX TESTING AND TREATMENT

Radiofrequency ablation is a proactive treatment for patients diagnosed with Barrett’s esophagus who want to reduce their risk of progression to esophageal cancer.

ERADICATE BARRETT’S ESOPHAGUS, REDUCE CANCER RISK

Barrett’s esophagus is the primary risk factor for esophageal adenocarcinoma (EAC), a form of esophageal cancer. Developing Barrett’s increases your chances of developing EAC by 50 times.1 Patients with confirmed low-grade dysplasia and other risk factors face a substantial risk of disease progression.2,3

Radiofrequency ablation (RFA) is a proactive treatment for patients diagnosed with Barrett’s esophagus who are under surveillance but want to reduce their risk of progression to EAC. RFA uses heat to remove precancerous tissue damaged by Barrett’s esophagus. The technology is designed for the removal of tissue affected by Barrett’s, while preserving the underlying healthy tissue.

Multiple studies demonstrate the effectiveness of RFA in treating Barrett’s esophagus.4-8 Additionally, clinical guidelines from the three gastrointestinal (GI) societies in the U.S. recommend treating patients with dysplasia with endoscopic eradication therapy such as RFA.9,10

WHAT TO EXPECT

BEFORE THE PROCEDURE

Follow the instructions specified by your physician or the nursing staff. The following instructions were given to patients in certain clinical trials and are provided here as an example of what you can expect:

  • No eating or drinking after midnight the day before the procedure.
  • Arrange to have someone drive you home after the procedure.
  • If you take aspirin or blood thinning medication, you will receive instructions from your doctor about when to stop taking them before each endoscopy.

DAY OF THE PROCEDURE

Ablation therapy is performed in conjunction with an upper endoscopy. The treatment is performed after the patient is sedated in an outpatient setting and no incisions are involved. While procedure time in clinical studies averaged 30 minutes, the actual time can vary depending on the physician’s experience and the difficulty of the case. You will be monitored after the procedure is complete.

AFTER THE PROCEDURE

Follow the discharge instructions provided by your physician after the RFA procedure. You may experience mild discomfort after the procedure, and your doctor may provide medications to help with your symptoms. 

Your physician will schedule a follow-up appointment within two to three months after the procedure. If any residual Barrett's tissue is found, your physician will ablate it. Regular monitoring with endoscopies and biopsies are recommended even after radiofrequency ablation therapy. 

Referenced path does not exist

1

De Jonge PJ et al. Risk of malignant progression in patients with Barrett’s oesophagus: a Dutch nationwide cohort study. Gut 2010;59:1030-1036.

2

Phoa KN, van Vilsteren FG, Pouw RE, Weusten BL, et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial. JAMA. 2014 Mar 26;311(12):1209-17

3

Spechler S. et al. Barrett’s Esophagus. N Engl J Med 2014; 371:836-45.

4

Phoa KN, van Vilsteren FG, Pouw RE, et al. Radiofrequency Ablation in Barrett’s Esophagus with Confirmed Low-Grade Dysplasia: Interim Results of a European Multicenter Randomized Controlled Trial (SURF). Gastroenterology 2013;144:S-187. Page S-187, Col 1

5

Orman ES, Li N, Shaheen NJ. Efficacy and durability of radiofrequency ablation for Barrett's esophagus: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11:1245-55

6

Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med 2009;360:2277-88. Page 2277, Page 2283, Figure 3

7

van Vilsteren FG, Pouw RE, Seewald S, et al. Stepwise radical endoscopic resection versus radiofrequency ablation for Barrett’s oesophagus with high-grade dysplasia or early cancer: a multicentre randomised trial. Gut 2011;60:765-73. Page 765, Col 1 and Page 769, Table 2

8

Phoa KN, Pouw RE, van Vilsteren FG, et al. Remission of Barrett’s Esophagus with Early Neoplasia 5 Years after Radiofrequency Ablation with Endoscopic Resection: A Netherlands Cohort Study.

9

Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus. The American Journal Of Gastroenterology. 2016;111(1):30-50

10

Wani S, Qumseya B, Sultan S, et al. Endoscopic eradication therapy for patients with Barrett’s esophagus-associated dysplasia and intramucosal cancer. Gastrointestinal Endoscopy. 2018;87(4):907-931.