Radiofrequency Ablation vs. Surveillance for Barrett Esophagus with Low-Grade Dysplasia

Rate of progression to high-grade dysplasia or esophageal adenocarcinoma was significantly lower with radiofrequency ablation.

Management strategies for Barrett esophagus (BE) patients with low-grade dysplasia (LGD) remain controversial. Recent “best-practice” recommendations state that LGD histologic diagnosis needs to be confirmed by a recognized expert pathologist, that high-definition endoscopy should be conducted in 8 to 12 weeks after twice-daily proton-pump inhibitor treatment, and that endoscopic ablation by radiofrequency ablation (RFA) should then be used for all patients with confirmed and persistent LGD (NEJM JW Gastroenterol Dec 2016 and Gastroenterology 2016; 151:822).

Investigators have now conducted a systematic review and meta-analysis involving 2746 patients with BE and LGE to compare risks for progression to high-grade dysplasia (HGD) and esophage…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors