title: Effectiveness of focal vs. balloon radiofrequency ablation devices in the treatment of Barrett's esophagus.
abstract: OBJECTIVE
  The safety and efficacy of radiofrequency ablation (RFA) in treatment of Barrett's esophagus (BE)-associated dysplasia has been well established. The effectiveness of focal and balloon RFA devices has not been compared. Therefore, the aim of our study was to assess the effectiveness of focal and balloon RFA devices in the treatment of BE by calculating absolute and percentage change in BE length with RFA therapy by comparing pre- and post-treatment BE length.
  
  
  METHODS
  This is a retrospective cross-sectional study of patients who underwent at least one treatment with either focal and/or balloon RFA devices who were identified from two tertiary centers. Patients' demographics, hiatal hernia, pre- and post-treatment BE length, prior use of endoscopic therapies and number of sessions were recorded.
  
  
  RESULTS
  Sixty-one patients who had undergone 161 RFA treatment sessions met inclusion criteria. There was no significant difference in percentage change in BE length with greater number of RFA sessions. RFA with a focal device resulted in greater percentage reduction in BE length compared to the balloon system (73% vs. 39%, p < 0.01). After adjusting for initial BE length, pre-treatment BE length, hernia status, prior endoscopic mucosal resection (EMR), prior RFA, and prior EMR/RFA sessions, RFA with a focal device at each session remained an independent predictor for a significant reduction in BE extent as compared to the balloon system.
  
  
  CONCLUSIONS
  The focal RFA device alone was more effective in treatment of BE compared to the balloon system, with a greater reduction in extent of BE. The focal RFA device for endoscopic eradication therapy of BE should be considered the preferred technique.
authors.affiliation: Gastroenterology and Hepatology, Veterans Affairs Medical Center, USA; Gastroenterology and Hepatology, University of Kansas Medical Center, USA.
authors.forename: Jesica
authors.initials: J
authors.lastname: Brown
authors.affiliation: Gastroenterology and Hepatology, Veterans Affairs Medical Center, USA; Gastroenterology and Hepatology, University of Kansas Medical Center, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Alsop
authors.affiliation: Gastroenterology, Loyola University, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Gastroenterology and Hepatology, University of Kansas Medical Center, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Buckles
authors.affiliation: Gastroenterology and Hepatology, University of Kansas Medical Center, USA.
authors.forename: Mojtaba S
authors.initials: MS
authors.lastname: Olyaee
authors.affiliation: Gastroenterology and Hepatology, Veterans Affairs Medical Center, USA.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Vennalaganti
authors.affiliation: Gastroenterology and Hepatology, Veterans Affairs Medical Center, USA; Gastroenterology and Hepatology, University of Kansas Medical Center, USA.
authors.forename: Vijay Naag
authors.initials: VN
authors.lastname: Kanakadandi
authors.affiliation: Gastroenterology and Hepatology, Veterans Affairs Medical Center, USA; Gastroenterology and Hepatology, University of Kansas Medical Center, USA.
authors.forename: Shreyas
authors.initials: S
authors.lastname: Saligram
authors.affiliation: Gastroenterology and Hepatology, Veterans Affairs Medical Center, USA; Gastroenterology and Hepatology, University of Kansas Medical Center, USA.
authors.forename: Prateek
authors.initials: P
authors.lastname: Sharma
keywords: Barrett’s; Focal radiofrequency ablation; circumferential radiofrequency ablation; esophageal cancer; high-grade dysplasia