Regional Gastrointestinal Consultants

Radiofrequency Ablation of Barretts

Radiofrequency Ablation of Barretts

WHAT IS Radiofrequency Ablation (RFA) Therapy

Radiofrequency ablation (RFA) therapy has been shown to be safe and effective for treating Barrett’s esophagus complicated by dysplasia. Radiofrequency ablation is a minimally invasive procedure that involves using radio waves, delivered via a catheter to the esophagus, to remove diseased tissue while minimizing injury to healthy esophagus tissue. This is called ablation, which means the removal or destruction of abnormal tissue.

Larger areas of Barrett’s tissue are treated with a balloon-mounted catheter. Smaller areas are treated with an endoscope-mounted catheter. Both are introduced during an upper GI endoscopy procedure, which is a thin, flexible tube inserted through a patient’s mouth.

RFA was first used to treat Barrett’s esophagus in 2005. Since then, more than 50 clinical studies have demonstrated the safety and efficacy of RFA for complete removal of Barrett’s esophagus, as well as reducing progression of dysplasia to esophageal cancer. These studies have demonstrated successful removal of dysplasia in more than 90% of patients undergoing therapy.

Patients with high-grade dysplasia often undergo an endoscopic ultrasound exam to ensure there is no deeper tissue involvement before undergoing RFA.

What happens during an RFA

RFA for Barrett’s esophagus is performed while the you are sedated, after which, an electrode mounted on a balloon catheter or endoscope is used to deliver heat energy directly to the diseased lining of the esophagus. Your gastroenterologist will choose one of three electrodes for the procedure. The predominant factor in which electrode is used will be the length/amount of Barrett’s esophagus to treat. The energy delivered by the electrode results in high temperature heating of the Barrett’s lining. This process typically takes 25 to 35 minutes and leads to ablation of the tissue.

This tissue sloughs off over 48 to72 hours following the procedure. Over a period of six to eight weeks, this tissue is replaced by normal (squamous) lining. For most patients, one to three RFA treatment sessions are required to remove all of the Barrett’s mucosa.
  
Patients who are treated with RFA return for a follow-up endoscopy in two to three months to ensure they are healing properly and to determine if additional treatment is required. Surveillance endoscopy is performed on a regular basis after all of the Barrett’s esophagus has been adequate.

WHAT TO EXPECT when having a RFA



 First, when you arrive at our office you will be welcomed by our thoughtful staff and a dedicated team of experts that deliver personalize care. To add to your comfort level, we strive to keep the same physicians and nursing staff with the patient throughout all your appointments at the center. In this way, the staff gets to understand the patient’s concerns and conditions, and you get to know the persons taking care of you on a personal level.

Also, we strive to make your visit as hassle free as possible. We accurately schedule visits in advance, provide convenient onsite parking, and keep your waiting period to an absolute minimum. This is achieved by the fact that no emergency procedures are placed in front of your scheduled time (such as in most hospitals). Also, we do not double book patient appointments, when you are scheduled to be treated that time is assigned only to you.

When undergoing an RFA, the following will apply to your procedural visit:

  • Before any procedure our staff will meet with you to address any last-minute questions you may have.
  • Do not eat or drink anything after midnight of the eve of your procedure date. All patients with Barrett’s esophagus will also be treated with high-dose antacids (typically in the proton pump inhibitor family) indefinitely. A low-acid environment helps the body replace the removed tissue with normal tissue (squamous mucosa). Patients will remain in a surveillance program indefinitely to ensure that the Barrett’s mucosa, or diseased tissue, does not recur.

  • Prior to the procedure you will get changed into one our fresh medical gowns using our private restrooms, or a private patient changing area.
  • Once you have changed into the medical gown you will relax and laydown on a padded procedure gurney and you will be transported a short distance to our modern operating room.
  • In the operating room, you will meet with your gastroenterologist before your endoscopy to discuss the procedure, if you would like, and thereafter be administered sedation so that the procedure may commence.
    • When being sedated you will receive the highest quality anesthesia, administered by highly experienced professionals who will standby you monitoring your sedation throughout the entire procedure.
  • The procedure itself will take between 25 to 35 minutes.
  • After the procedure, you will be brought back into the post anesthesia recovery area where you will relax until the sedation has worn off.
    • After speaking with most patients about their procedure, patients universally comment (paraphrasing of course); “I remember getting changed, laying on the gurney, meeting with my doctor and waking up waiting for the procedure to start”. Once they find out the procedure was completed already, there is usually a couple chuckles they have with our staff.
  • With all that being said, once you are alert from your anesthesia, fully dressed and comfortable, you will meet with your physician to discuss the procedure results, before heading home.
    • A special note, because you will be sedated for the procedure, you will need to have someone to drive you home even after the sedation has initially worn off, though you may feel fine, your reflexes may be slower than usual until the anesthesia is completely out of your system which can take between 1 to 3 hours after the procedure.
  • Also, most patients can return to a normal eating habits immediately after an endoscopic procedure.

The most important thing to remember is not to worry! Our gastroenterologist are highly experienced physicians and we have completed thousands of endoscopies / RFAs, also we supply our gastroenterologist with only the best equipment to increase safety, as well as diagnostic and treatment effectiveness. Last, but certainly not least, please ask any questions you may have of your healthcare team, who will be there for you during and after your procedure, and all of whom are dedicated to ensure you receive the best care possible.

IMPORTANT HEALTH NOTE

We recommend that people experiencing gastrointestinal symptoms do not attempt self-treatment. With many medications being available over the counter, and numerous do-it-yourself online unqualified remedy recommendation, it is natural to consider treating yourself but we highly recommend against this.

If you are experiencing gastrointestinal symptoms you may have a more significant issue than you would expect from the sometimes muted or infrequent symptom you may be experiencing. It is important to keep in mind that is you are having gastrointestinal symptoms or concerns it is best see a doctor to have those symptoms diagnosed and any conditions treated. Also, it is worth noting, that if health conditions do exist, the earlier they are diagnosed and treated, the greater the probability will be to successfully eliminate or manage a present condition, in fact successful outcomes will increase significantly with early detection.

If you have gastrointestinal concerns or are experiencing any gastrointestinal symptoms, please contact us promptly to schedule a consultation with a physician.


DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general information. In no way, does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a best in class physician regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today at (215) 321-4700 to schedule a consultation.