Background and aims:
Barrett's esophagus (BE) is a frequent disease. Therapy by radiofrequency ablation (RFA) has been shown in literature to be an effective eradication therapy of BE, with a reasonable frequency of complications. The aim of our study is to compare the efficacy and complications of the treatment of BE by RFA in our center to those of literature, as a quality control.
Methods:
We collected the data of patients who underwent RFA treatment of BE between January 1st 2011 and July 31st 2015. This included 32 patients, 20 of which completed the therapy by the end of the study period. The data was taken from histological and endoscopical medical reports as well as clinical follow-up reports for certain patients. The primary outcome was the efficacy of treatment, including whether there was a complete eradication of intestinal metaplasia (CE-IM) or of dysplasia (CE-D). The secondary outcome was to assess any post-RFA complications. These included progression to adenocarcinoma under treatment, upper gastro-intestinal (GI) hemorrhage, stenosis and pain. We compared our results to those of literature.
Results:
CE-D was achieved in 93.8% of the patients, whereas CE-IM was achieved in 61.1% of the patients. However, there were 11.11% of the patients who only had microislets of residual metaplasia. In a meta-analysis from Orman and al, CE-D was achieved in 91% of patients and CE-IM in 78% of patients. In our cohort, one patient progressed to adenocarcinoma, 4 patients had upper-GI hemorrhage and 2 patients had esophageal stenosis. Of the 17 patients who benefitted from a systematic clinical follow-up, 2 patients had fever after the RFA session and 10 described pain (odynodysphagia, epigastralgia or retrosternal pain). These complications were all previously described in literature.
Conclusion:
The efficacy of radiofrequency ablative therapy of Barrett's esophagus in the University hospital of Lausanne is comparable to that described in literature in terms of CE-D, but not in terms of CE-IM. The post-RFA complications were qualitatively comparable to those of literature.