title: A systematic review of the evidence for radiofrequency ablation for Barrett's esophagus.
abstract: BACKGROUND
  Radiofrequency ablation with the HALO system is a new option for the treatment of patients with Barrett's esophagus. This systematic review summarizes the results of all relevant publications on this topic to answer patient-relevant clinical questions and to evaluate the potential benefit and harm of this new therapy.
  
  
  METHODS
  A systematic literature search of MEDLINE and CENTRAL up to May 2009 was performed. To identify the relevant literature, references were evaluated by two reviewers independently. The inclusion criteria for the review required that studies investigated patients with Barrett's esophagus, used radiofrequency ablation as the intervention, and had a minimum follow-up period of 12 months.
  
  
  RESULTS
  A total of nine relevant observational studies (involving 429 patients) were identified. Complete eradication of Barrett's esophagus dysplasia and metaplasia was achieved respectively for 71-100% and for 46-100% of the patients. Only six cases of stenosis and one case of buried intestinal metaplasia were reported among all the patients. Only a few mild adverse events were reported.
  
  
  CONCLUSIONS
  Based on the evidence of observational studies, the summary of the current data suggests that radiofrequency ablation with the HALO system could be a promising method associated with a low complication rate, low risk of stricture formations, and a minor probability of buried glands. To evaluate the potential benefit at a higher level of evidence, randomized controlled trials (RCTs) involving a direct comparison with other more established endoscopic methods such as photodynamic therapy are necessary.
authors.affiliation: Department of Internal Medicine, Evidence Based Medicine Review Center, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria. thomas.semlitsch@medunigraz.at
authors.forename: Thomas
authors.initials: T
authors.lastname: Semlitsch
authors.forename: Klaus
authors.initials: K
authors.lastname: Jeitler
authors.forename: Rainer
authors.initials: R
authors.lastname: Schoefl
authors.forename: Karl
authors.initials: K
authors.lastname: Horvath
authors.forename: Nicole
authors.initials: N
authors.lastname: Pignitter
authors.forename: Franz
authors.initials: F
authors.lastname: Harnoncourt
authors.forename: Andrea
authors.initials: A
authors.lastname: Siebenhofer
mesh_terms: D001471:Barrett Esophagus / Q000601:surgery*; D017115:Catheter Ablation; D019317:Evidence-Based Medicine; D006801:Humans
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