Ablation Therapy for Barrett Esophagus

Ablation Therapy for Barrett Esophagus

Allon Kahn, MD

Cadman L. Leggett, MD

Ablation therapy for Barrett esophagus (BE) consists of the application of thermal energy (radiofrequency ablation), a cryogen (cryoablation), or a photosensitizer (photodynamic therapy) to induce superficial tissue injury and necrosis. Radiofrequency ablation (RFA) and cryoablation are safe, effective, and durable modalities that are considered the current standard of care in ablation therapy. It is important that patients with BE treated with ablation therapy be enrolled in a comprehensive surveillance program.


  • 1. The patient must be instructed to fast overnight prior to the procedure, in order to ensure clearance of gastric contents. This is important both to minimize risk for aspiration and to ensure adequate function of ventilation tubing with cryotherapy.

  • 2. Informed consent must be obtained prior to beginning the procedure. Possible adverse events and complications should be explained to the patient in sufficient detail.

  • 3. Deep sedation or general anesthesia is commonly employed due to the length of the procedure and associated pain.

  • 4. Antiplatelet therapy and/or anticoagulation should be held prior to the procedure if clinically appropriate


RFA is a bipolar thermal ablative modality that requires contact between an electrode array and the esophagus. Circumferential RFA is performed in patients with a BE segment >2 cm in length, while focal RFA is performed to treat shorter segments or as follow-up to circumferential ablation. Fig. 9.1 highlights the steps involved in RFA.

May 29, 2020 | Posted by in GASTROENTEROLOGY | Comments Off on Ablation Therapy for Barrett Esophagus

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