Background: Ablation of Barrett's esophagus (BE) has been advocated as a method to eliminate the risk of malignant transformation of BE.
Objective: To provide longer follow-up and determine safety and efficacy of multipolar ablation for nondysplastic BE.
Design: Prospective cohort study.
Setting: Gastroenterology Unit at the Policlinica Metropolitana, a tertiary care center in Caracas, Venezuela.
Patients: One hundred sixty-six patients with nondysplastic BE and histologic evidence of intestinal metaplasia.
Interventions: Patients underwent multipolar electrocoagulation ablation therapy to areas of BE identified with magnification chromoendoscopy. The identified areas were treated with a 50-W energy source and a 7F "gold" probe. After complete ablation, patients were followed on an annual basis with magnification chromoendoscopy. At annual visits, biopsy specimens were taken in areas identified at baseline as BE. Targeted biopsy specimens were taken in areas of recurrent BE identified by using magnification chromoendoscopy.
Main Outcome Measurements: Mortality, incidence of recurrent BE, incidence of adenocarcinoma in ablated BE, and morbidity associated with multipolar electrocoagulation.
Results: One hundred sixty-six patients were recruited for the study; 139 completed at least 10 years of follow-up. Complications developed in less than 5% of patients, all of which were minor. Recurrent BE occurred in less than 5% of patients. No adenocarcinoma or high-grade dysplasia of the esophagus developed in any of the patients.
Limitation: Uncontrolled clinical trial.
Conclusions: Long-term follow-up of ablation of BE with multipolar electrocoagulation ablation therapy indicates that this is a safe, effective method to ablate BE over the long term.
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