title: Limitations of endoscopic ablation in Barrett's esophagus.
abstract: In the last 5-10 years, endoscopic ablative therapies have been gaining ground as treatment for Barrett's esophagus associated with high-grade dysplasia and early cancer, and they are becoming the most preferred technique over surgery as the standard of care. These therapies are associated with a lower rate of complications and mortality than surgery; studies have found them to be safe, effective and tolerable. Endoscopic ablative therapies are not, however, without their drawbacks. There is a paucity of data on long-term efficacy, and direct comparisons of the different modalities are lacking. Unlike surgery, current data suggest that endoscopic ablation treatments may not be curative in all patients, so patients require ongoing surveillance and acid suppression. Questions remain regarding durability as well as factors promoting recurrence after endoscopic therapy. The authors conducted a systematic review of the literature on ablative therapies in Barrett's esophagus to describe the modalities currently available and to provide an understanding of their limitations.
authors.affiliation: Department of Internal Medicine, Creighton University Medical Center, 601 N 30th Street, Omaha, NE 68131, USA.
authors.forename: Avyakta
authors.initials: A
authors.lastname: Kallam
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Alsop
authors.forename: Prateek
authors.initials: P
authors.lastname: Sharma
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects* / Q000401:mortality; D001471:Barrett Esophagus / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004945:Esophagoscopy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Barrett’s esophagus; ablation therapies; cryoablation; limitations of ablation therapy; photodynamic therapy; radiofrequency ablation; recurrences in ablation therapy