Abstract:

Recently, extensive data has been published about the safety and efficacy of endoscopic radiofrequency ablation (RFA) of Barrett's esophagus (BE) with early cancer and dysplasia as well as without dysplasia. RFA has been shown to be effective and safe. Circumferential RFA is delivered using the HALO360+ Ablation System (Covidien,Inc., Mansfield, MA), which consists of a high-power energy generator, a sizing balloon catheter, and a number of balloon-based ablation catheters with varying outer diameters. Focal RFA is delivered using the HALO90 or HALO60 Ablation Systems (Covidien,Inc., Mansfield, MA), consisting of a radiofrequency energy generator and an endoscope-mounted electrode. Both RFA systems have official approval to be used in the United States, Europe, and other countries for the treatment of BE as well as in patients with gastric antral vascular ectasia and radiation proctopathy. With increasing widespread use of these systems, a full mastery of the equipment and therapeutic technique is essential to maximize eradication rates of BE while maintaining patient safety. The cost-effective patient selection and eradication protocol for RFA are essential to success with this technique in patients with BE. This article will discuss our experience with RFA treatment of BE using the HALO system for effective eradication of Barrett's dysplasia and early Barrett's cancer and available data especially from the U.S. National Registry.

Authors:

David S. Wolf, MD Assistant Professor, University of Texas Medical School, Houston, TX, Brian J. Dunkin, MD, FACS, Professor of Surgery, Weill Cornell Medical College Medical Director, Methodist Institute for Technology, Innovation, and Education The Methodist Hospital Department of Surgery, Houston, TX, Atilla Ertan, MD, FACP, AGAF, MACG Professor of Medicine University of Texas Medical School Medical Director Gastroenterology Center of Excellence, Houston, TX

PMID: 23292670

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