Ablation of Barrett's esophagus using the HALO radiofrequency ablation system

被引:6
作者
Sharma, Virender K. [1 ]
机构
[1] Ctr Digest Hlth, Gilbert, AZ USA
关键词
Barrett's esophagus; Dysplasia; Esophageal cancer; Esophageal adenocarcinoma; Ablation;
D O I
10.1016/j.tgie.2010.01.007
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The incidence of esophageal adenocarcinoma is rising at an epidemic rate. Barrett's esophagus (BE) is its only known precursor lesion and is an ideal target for endoprevention of esophageal adenocarcinoma. Recent advances in endoscopic therapy, especially radiofrequency ablation (RFA) using the HALO system have renewed interest in ablative therapies for the management of BE. RFA uses a bipolar electrode array to deliver thermal energy to the metaplastic and dysplastic Barrett's tissue for large-area circumferential and small-area focal ablation. Multiple prospective uncontrolled trials, case series, and registries have consistently shown safety and effectiveness of RFA in treating all stages of BE. A large multicenter sham-controlled trial showed that in patients with either low-grade or high-grade dysplasia, RFA is effective in ablating esophageal intestinal metaplasia and dysplasia and preventing progression to higher grades of dysplasia and cancer. In addition, cost-effectiveness models have shown ablation may be a cost-effective strategy for the management of all stages of BE. This article is a review of technical background of RFA using the HALO system and is a summary of the data on its current applications for the treatment of BE. (C) 2010 Published by Elsevier Inc.
引用
收藏
页码:26 / 34
页数:9
相关论文
共 24 条
[1]   Stepwise radiofrequency ablation of Barrett's esophagus preserves esophageal inner diameter, compliance, and motility [J].
Beaumont, H. ;
Gondrie, J. J. ;
McMahon, B. P. ;
Pouw, R. E. ;
Gregersen, H. ;
Bergman, J. J. ;
Boeckxstaens, G. E. .
ENDOSCOPY, 2009, 41 (01) :2-8
[2]   An economic analysis of endoscopic ablative therapy for management of nondysplastic Barrett's esophagus [J].
Das, A. ;
Wells, C. ;
Kim, H. J. ;
Fleischer, D. E. ;
Crowell, M. D. ;
Sharma, V. K. .
ENDOSCOPY, 2009, 41 (05) :400-408
[3]   Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device [J].
Dunkin, BJ ;
Martinez, J ;
Bejarano, PA ;
Smith, CD ;
Chang, K ;
Livingstone, AS ;
Melvin, WS .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2006, 20 (01) :125-130
[4]   Radiofrequency Ablation of Barrett's Esophagus: Short-Term Results [J].
Eldaif, Shady M. ;
Lin, Edward ;
Singh, Kimberly A. ;
Force, Seth D. ;
Miller, Daniel L. .
ANNALS OF THORACIC SURGERY, 2009, 87 (02) :405-411
[5]   Endoscopic ablation of Barrett's esophagus: a multicenter study with 2.5-year follow-up [J].
Fleischer, David E. ;
Overholt, Bergein F. ;
Sharma, Virender K. ;
Reymunde, Alvaro ;
Kimmey, Michael B. ;
Chuttani, Ram ;
Chang, Kenneth J. ;
Lightdale, Charles J. ;
Santiago, Nilda ;
Pleskow, Douglas K. ;
Dean, Patrick J. ;
Wang, Kenneth K. .
GASTROINTESTINAL ENDOSCOPY, 2008, 68 (05) :867-876
[6]   Endoscopic Ablation of Barrett's Esophagus Using the Halo® System [J].
Fleischer, David E. ;
Sharma, Virender K. .
DIGESTIVE DISEASES, 2008, 26 (04) :280-284
[7]   Complete ablation of esophageal epithelium with a balloon-based bipolar electrode: a phased evaluation in the porcine and in the human esophagus [J].
Ganz, RA ;
Utley, DS ;
Stern, RA ;
Jackson, J ;
Batts, KP ;
Termin, P .
GASTROINTESTINAL ENDOSCOPY, 2004, 60 (06) :1002-1010
[8]   Circumferential ablation of Barrett's esophagus that contains high-grade dysplasia: a US multicenter registry [J].
Ganz, Robert A. ;
Overholt, Bergein F. ;
Sharma, Virender K. ;
Fleischer, David E. ;
Shaheen, Nicholas J. ;
Lightdale, Charles J. ;
Freeman, Stephen R. ;
Pruitt, Ronald E. ;
Urayama, Shiro M. ;
Gress, Frank ;
Pavey, Darren A. ;
Branch, M. Stanley ;
Savides, Thomas J. ;
Chang, Kenneth J. ;
Muthusamy, V. Raman ;
Bohorfoush, Anthony G. ;
Pace, Samuel C. ;
DeMeester, Steven R. ;
Eysselein, Viktor E. ;
Panjehpour, Masoud ;
Triadafilopoulos, George .
GASTROINTESTINAL ENDOSCOPY, 2008, 68 (01) :35-40
[9]   Pilot series of radiofrequency ablation of Barrett's esophagus with or without neoplasia [J].
Hernandez, J. C. ;
Reicher, S. ;
Chung, D. ;
Pham, B. V. ;
Tsai, F. ;
Disibio, G. ;
French, S. ;
Eysselein, V. E. .
ENDOSCOPY, 2008, 40 (05) :388-392
[10]   ASGE guideline: the role of endoscopy in the surveillance of premalignant conditions of the upper GI tract [J].
Hirota, WK ;
Zuckerman, MJ ;
Adler, DG ;
Davila, RE ;
Egan, J ;
Leighton, JA ;
Qureshi, WA ;
Rajan, E ;
Fanelli, R ;
Wheeler-Harbaugh, J ;
Baron, TH ;
Faigel, DO .
GASTROINTESTINAL ENDOSCOPY, 2006, 63 (04) :570-580