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A systematic review of the evidence for radiofrequency ablation for Barrett's esophagus.
MedLine Citation:
PMID:  20464420     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Radiofrequency ablation with the HALO system is a new option for the treatment of patients with Barrett's esophagus. This systematic review summarizes the results of all relevant publications on this topic to answer patient-relevant clinical questions and to evaluate the potential benefit and harm of this new therapy.
METHODS: A systematic literature search of MEDLINE and CENTRAL up to May 2009 was performed. To identify the relevant literature, references were evaluated by two reviewers independently. The inclusion criteria for the review required that studies investigated patients with Barrett's esophagus, used radiofrequency ablation as the intervention, and had a minimum follow-up period of 12 months.
RESULTS: A total of nine relevant observational studies (involving 429 patients) were identified. Complete eradication of Barrett's esophagus dysplasia and metaplasia was achieved respectively for 71-100% and for 46-100% of the patients. Only six cases of stenosis and one case of buried intestinal metaplasia were reported among all the patients. Only a few mild adverse events were reported.
CONCLUSIONS: Based on the evidence of observational studies, the summary of the current data suggests that radiofrequency ablation with the HALO system could be a promising method associated with a low complication rate, low risk of stricture formations, and a minor probability of buried glands. To evaluate the potential benefit at a higher level of evidence, randomized controlled trials (RCTs) involving a direct comparison with other more established endoscopic methods such as photodynamic therapy are necessary.
Authors:
Thomas Semlitsch; Klaus Jeitler; Rainer Schoefl; Karl Horvath; Nicole Pignitter; Franz Harnoncourt; Andrea Siebenhofer
Publication Detail:
Type:  Journal Article     Date:  2010-05-13
Journal Detail:
Title:  Surgical endoscopy     Volume:  24     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2935-43     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Evidence Based Medicine Review Center, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria. thomas.semlitsch@medunigraz.at
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