Barrett’s Esophagus Ablation
Ablation therapy is a treatment for Barrett’s esophagus, a gastrointestinal condition that is closely associated with long-term gastroesophageal reflux disease (GERD). The effects of GERD cause the surface of parts of the esophagus to change, and increases a person’s risk for esophageal cancer. Ablation therapy is a type of minimally invasive procedure (no incisions required/small puncture/low to moderate sedation) performed to destroy the abnormal tissue.
Ablation therapy is an endoscopic procedure. Using a catheter with an endoscope, which is a thin tube with a light and camera on the end that a physician passes through the patient’s mouth, down the throat, and into the esophagus, the physician views the inside of the upper gastrointestinal tract and targets areas of the esophagus for treatment. Through the catheter, intense energy is delivered to the abnormal tissue, which destroys it, slowing or preventing the development of esophageal cancer.
Energy may be delivered in different ways, including radiofrequency ablation, cryotherapy, or hybrid argon plasma coagulation.
Radiofrequency Ablation (RFA)
Radiofrequency ablation is an FDA-approved technique in which heat energy is used to destroy the abnormal cells. When the area heals, the abnormal cells are replaced by normal esophageal cells. Oftentimes, a few sessions of radiofrequency ablation about 3 months apart are needed to fully remove the damaged cells.
Cryotherapy
- Also known as cryosurgery or cryoablation, cryotherapy is an FDA-approved technique where a balloon is inflated in the esophagus and nitrous oxide is released within the balloon. The balloon contacts the esophagus lining, freezing it to temperatures that ablate or destroy the superficial lining of the esophagus, and thus removing the Barrett’s. Normal cells grow in its place when the esophagus heals. Usually, one session every three months is required till the Barrett’s is gone. Studies have shown that cryotherapy can be especially useful when radiofrequency ablation (RFA) is not working. It is also less painful than RFA.
Hybrid APC
- This is a newer FDA-approved technique where the tissue is injected with saline to create a cushion in the deeper layers. The superficial layer is then ablated with argon plasma coagulation (a form of heat therapy). Preliminary studies show this can be very useful when other modalities are failing.