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What is Radiofrequency Ablation?

Radiofrequency ablation is the use of high-energy radio waves to destroy abnormal cells and tissue. This procedure can be used by surgeons for endoscopic eradication of Barrett’s esophagus.

What is Barrett’s Esophagus?

Barrett’s esophagus is a potentially serious condition in which the cells lining the inner wall of the esophagus, which connects the mouth to the stomach, start transforming into cells which are similar to the cells lining the small intestine. This occurs due to frequent acid reflux into the esophagus.

Risks of Barrett’s Esophagus

When left untreated, Barrett’s esophagus may progress to a precancerous state in some patients. If the precancerous cells are not eradicated, the condition can lead to gastric cancer.

Indications for Radiofrequency Ablation for Barrett’s Esophagus

All patients with advanced cancerous changes in the cells of the esophagus need to be treated with radiofrequency ablation. In patients with low-grade cancerous changes of the cells, radiofrequency ablation remains a treatment option, but your surgeon may also choose to closely monitor the condition with an endoscopic biopsy performed at regular intervals.

Benefits of Radiofrequency Ablation for Barrett’s Esophagus

Radiofrequency ablation has a high success rate of about 80-90% in completely removing the abnormal cells in patients with Barrett’s esophagus.

Preparation for Endoscopic Radiofrequency Ablation for Barrett’s Esophagus

Your surgeon will provide specific instructions to prepare you for the procedure. In general:

  • Inform your doctor of any allergies or regular medications.
  • Blood-thinning medications will need to be stopped a few days prior to surgery.
  • Do not eat or drink anything 8-12 hours prior to the surgery.
  • Arrange for someone to drive you home after the procedure.

Endoscopic Radiofrequency Ablation Procedure for Barrett’s Esophagus

  • The procedure is usually done in the outpatient setting.
  • You will be given sedation and an upper gastrointestinal endoscopy will be performed.
  • The endoscope is a thin flexible tube attached to a miniaturized camera that is inserted through your mouth and passed into the stomach for magnified viewing of the lining of the esophagus, stomach, and upper part of the intestine.
  • Once the abnormal Barrett’s tissue is identified, an ablation catheter is inserted through the endoscope to deliver the radio waves which selectively destroy the normal tissue.
  • Depending on the severity of the condition, 1-3 treatment sessions will be required.

Recovery after Endoscopic Radiofrequency Ablation Procedure for Barrett’s Esophagus

  • Recovery from sedation may take about 30-60 minutes.
  • Numbing solutions and pain medications may be provided to alleviate chest discomfort.
  • You can return to work the next day.
  • A soft diet is recommended for a few days after the procedure.

Risks and Complications of Radiofrequency Ablation

Radiofrequency ablation for Barrett’s esophagus is very safe; however, there is a minimal risk of complications that include bleeding and narrowing of the esophagus.

Other Endoscopic Eradication Methods for Barrett’s Esophagus

Other endoscopic eradication methods for Barrett’s esophagus include:

  • Endoscopic Photodynamic Therapy: This procedure involves the use of a laser which is passed through the endoscope to destroy the abnormal tissue. Prior to the therapy, the patient is given a medicine that makes the cells sensitive to the laser.
  • Endoscopic Mucosal Resection: This procedure involves the lifting up and cutting of the abnormal tissue lining the esophagus using endoscopic instruments
  • Endoscopic Spray Cryotherapy: This procedure involves the use of cold carbon dioxide or nitrogen gas to destroy the abnormal tissue by freezing.

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