S482 The Use of Multipolar Coagulation for Completion of Barrett Esophagus Ablation With Radiofrequency Ablation

Objective We sought to evaluate clinicopathologic features of patients who underwent esophageal surgery after radiofrequency ablation (RFA) treatment using the HALO system for Barrett esophagus (BE) with high-grade dysplasia (HGD). Methods We evaluated patients from our hospital database who underwent esophagectomy from August 2006 to January 2012 after previously receiving RFA for BE. Information on demographics, time between RFA and surgery, indications for surgery, and final esophageal pathology was collected. Results In our study, we selected 102 patients who underwent esophagectomy. Five patients had a history of RFA for BE with HGD. Three patients were referred because of persistent HGD despite RFA, and all three patients had HGD in the esophagectomy specimen. Two patients presented with a benign diagnosis (esophageal perforation and leiomyoma), and both of these patients had pathologic stage T3N2M0 adenocarcinoma of the esophagus in the resected specimen. One of these patients had normal mucosa overlying carcinoma in the muscularis propria and adventitia. The patients with stage T3N2M0 cancer did not have pre-RFA endoscopic ultrasound, first treatment of RFA with HALO360, or surveillance endoscopic biopsy every 3 months. Conclusions Radiofrequency ablation for BE with HGD may mask underlying esophageal cancer. Patients who are counseled to undergo RFA for HGD should be aware that RFA could lead to delayed diagnosis and delayed treatment of invasive esophageal cancer without careful patient selection, appropriate RFA use, and close surveillance.

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963 Length of Proximal Extent of Subsquamous Intestinal Metaplasia Correlates With Difficult Eradication of Barrett Esophagus by Radiofrequency Ablation

Gastroenterology ◽

10.1016/s0016-5085(13)60621-6 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-174 ◽

Cited By ~ 1

Author(s):

Tsung-Han Tsai ◽

Hsiang-Chieh Lee ◽

Yuankai K. Tao ◽

Osman O. Ahsen ◽

Kaicheng Liang ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Intestinal Metaplasia ◽

Barrett Esophagus

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Endoscopic Management of Barrett’s Esophagus and Early Esophageal Neoplasia

10.2310/7800.16051 ◽

2019 ◽

Author(s):

Amanpal Singh ◽

Andrew J Bain ◽

Ramon Rivera

Keyword(s):

Esophageal Cancer ◽

Radiofrequency Ablation ◽

High Risk ◽

Acid Reflux ◽

Barrett Esophagus ◽

Endoscopic Management ◽

Early Esophageal Cancer ◽

Esophageal Neoplasia ◽

Risk Patients ◽

Ablative Techniques

Gastroesophageal reflux disease is common in North America, affecting around 25% of the population. A small fraction of these patients develop Barrett esophagus and thus are at a risk of developing esophageal cancer. The progression of Barrett esophagus to esophageal cancer can be prevented with timely examinations and, when necessary, by performing treatments to eradicate it. This review describes the use of endoscopy techniques to diagnose and classify Barrett esophagus among high-risk patients and the use of ablative techniques in patients with dysplasia. The review also describes endoscopic resection techniques for early esophageal cancer, which can provide staging information as well as can be therapeutic in selected cases. This review contains 8 figures and 49 references. Key Words: acid reflux, Barrett esophagus, cryoablation, endoscopic mucosal resection, endoscopic submucosal dissection, esophageal cancer, esophagus ablation, GERD, radiofrequency ablation

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