RADIOFREQUENCY ABLATION IN TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE WITH BARRETT’S ESOPHAGUS

Abstract

OBJECTIVE: To evaluate results of treatment of patients with Barrett’s esophagus, including radiofrequency ablation of columnar epithelium with antireflux surgery. METHODS: We treated82 patients with gastroesophageal reflux disease withBarrett’s esophagus between 2011 and 2018. 4 patients had low-grade dysplasia, 63 patients had hiatal hernia. We performed laparoscopic Toupet 2700 fundoplication in 58 of these patients.This allowedto perform radiofrequency ablation (RFA) procedure 2-3 months later in 27 of these patients. In 12 patients without radiological signs of hiatal hernia we performed RFA as the first treatment step. Follow-up endoscopy was performed 3,6 and 12 months after RFA. RESULTS: Metaplasia eradication wasachieved in 97,5% after 1 procedure and in 100% after 2 procedures. 6 months after treatment recurrence of metaplasia was registered in 2,4% patients. CONCLUSIONS: Changing security profile of new endoscopic treatment methods indicates the need for new strategies for Barrett’s esophagus. The most effective scheme is two-step treatment including antireflux surgery and radiofrequency ablation in combination with drug therapy.