French registry of endoscopic radiofrequency ablation of Barrett's oesophagus with dysplasia or neoplasia: methods and results

Radiofrequency ablation of the oesophagus (RFAO) is one of the many endoscopic treatment methods available for Barrett's oesophagus. Its effectiveness and low morbidity of moderate severity has been demonstrated in prospective and/or randomised trials. To describe the day-to-day use of RFAO, its results and the lesions it is to be used on by the experts, since becoming available in France. Retrospective national study of first 100 patients that had been treated, either partially or totally, by RFAO. Among the first 100 patients, only 94 were affected by Barrett's oesophagus without dysplasia (N = 20), with low grade dysplasia (N = 26), with high grade dysplasia (N = 40) or carcinoma (N = 8) after an initial endoscopic treatment, which was used on 41 patients. After 98 sessions of circular RFAO on 78 patients, and 80 sessions of sector-based RFAO on 52 patients, and a follow-up after five months (extr: 1-28) after the first session of RFAO, a disappearance in developed lesions (carcinoma or HGD) was achieved in 78% of patients, and for low developed lesions (LGD or OBND) in 52% of patients. Complete eradication of carcinoma and/or dysplastic type lesions, including intestinal metaplasia, was achieved in 44% (N = 23/53) of cases of carcinogenic or dysplastic lesions and for 27/66 (41%) of all patients (30% with loss seen). Oesophageal stenosis occurred in five patients (5.6%), which was corrected after two endoscopic hydraulic dilations. Our retrospective study confirms the effectiveness of RFAO in the removal of dysplastic lesions, 66% with low morbidity of moderate severity (4.5%) and a rate of 5.6% in corrective oesophageal stenosis. It also showed that 34% of treatments using RFAO were used in France in patients with Barrett's oesophagus without dysplasia or carcinoma.