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Ablation Eradicates Disease in Barrett's Esophagus

Study finds radiofrequency ablation completely eradicates intestinal metaplasia and dysplasia

WEDNESDAY, May 27 (HealthDay News) -- Radiofrequency ablation is effective in completely eradicating intestinal metaplasia and dysplasia in patients with Barrett's esophagus, according to a study in the May 28 issue of the New England Journal of Medicine.

Nicholas J. Shaheen, M.D., from the University of North Carolina in Chapel Hill, and colleagues randomly assigned 127 patients with dysplastic Barrett's esophagus to endoscopic radiofrequency ablation or a sham procedure in a 2:1 ratio.

The researchers found that radiofrequency ablation was effective in completely eradicating intestinal metaplasia (77.4 versus 2.3 percent) and was effective in eradicating dysplasia among patients with low-grade and high-grade dysplasia. Significantly fewer patients undergoing ablation had disease progression (3.6 versus 16.3 percent) and cancers (1.2 versus 9.3 percent). Adverse effects of ablation included chest pain, upper gastrointestinal hemorrhage, and esophageal stricture.

"In patients with dysplastic Barrett's esophagus, radiofrequency ablation was associated with a high rate of complete eradication of both dysplasia and intestinal metaplasia and a reduced risk of disease progression," Shaheen and colleagues conclude.

The study was supported by BARRX Medical and the study medication (esomeprazole) was provided by AstraZeneca. Many authors reported financial or consulting relationships with these companies and others.

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