title: Radiofrequency ablation in the management of Barrett's esophagus - preliminary own experience.
abstract: BACKGROUND
  Barrett's esophagus develops as a result of chronic injury of esophagus epithelium from gastroesophageal reflux disease. It is defined when metaplastic columnar epithelium replaces the stratified squamous epithelium which normally lies in the distal esophagus. The condition represents a risk factor for esophageal adenocarcinoma. The aim of the radiofrequency ablation (RFA) method is to destroy metaplastic epithelium with radiofrequency electric current and to stimulate reappearance of the flat multilayer epithelium in the distal esophagus.
  
  
  OBJECTIVE
  To evaluate the efficiency and safety of the RFA technique, newly introduced in Poland, in the management of Barrett's esophagus.
  
  
  METHODS
  Twelve patients were treated with the RFA method. Patients with Barrett's esophagus confirmed in the histopathological report were qualified for treatment. Two RFA techniques were applied using a BARRX(®) device: circular based on the balloon HALO(360) system or focal based on the HALO(90) system mounted to the endoscopic ending. The procedures were performed at 2-month intervals. The macroscopic and microscopic effects of RFA therapy, the patients' treatment tolerance as well as potential complications were evaluated.
  
  
  RESULTS
  In the group of 12 patients subjected to RFA therapy, 10 completed the therapeutic cycle. A total of 37 procedures were performed: 5 HALO(360) and 32 HALO(90). In all patients eradication of the abnormal metaplastic esophageal epithelium was achieved, as confirmed in both endoscopic and histopathological evaluation. In 2 patients with ongoing therapy progressive eradication of metaplastic epithelium was observed. No significant RFA-related complications were reported.
  
  
  CONCLUSIONS
  Based on our preliminary results we consider this method to be promising, free of significant complications and well tolerated by patients. In most patients it results in successful eradication of metaplastic epithelium in the distal esophagus.
authors.affiliation: Department of General and Hematological Surgery, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
authors.forename: Wojciech P
authors.initials: WP
authors.lastname: Dąbrowski
authors.forename: Andrzej B
authors.initials: AB
authors.lastname: Szczepanik
authors.forename: Andrzej
authors.initials: A
authors.lastname: Misiak
authors.forename: Konrad
authors.initials: K
authors.lastname: Pielaciński
keywords: Barrett's esophagus; metaplasia; radiofrequency ablation