Radiofrequency ablation treatment is a new treatment for Barrett’s oesophagus. Read on if you would like to understand the technical steps for this treatment. If you prefer to read about why you might want this treatment.
RFA for Barrett’s oesophagus
The treatment is performed at endoscopy. It takes up to an hour to do and can be done under sedation. It does not require a full general anaesthetic.
There are different types of sedation. The usual drugs used are benzodiazepines such as midazolam together with strong pain killers such as fentanyl. These can be given by the endoscopist. They make the patient very sleepy. Most people will have no recollection of the treatment. Some people will, however, remember what is happening. This is particularly so for people who have had many previous endoscopies.
Other drugs such as propofol behave more like a general anaesthetic and put the patient to sleep. These are usually given by an anaesthetist. Patients wake up very quickly after this medicine is given and usually do not have the after-effects of full anaesthesia. Please discuss the type of sedative you are going to have with your doctor.
Most people will have the treatment done as a day-patient and will go home later the same day. For some people, it is better to stay in hospital overnight. This is decided on a case-by-case basis.
Different Types of RFA Treatment
There are two types of RFA treatment:
Circumferential HALO-360 treatment procedure:
The treatment involves these steps:
Follow Up after Circumferential HALO Treatment
Once the treatment is completed, the patient goes home. Another treatment is offered 2-3 months later. Usually, the second treatment will be a non-circumferential method. This is because most of the Barrett’s will have already been eradicated. The next treatment is to remove any residual areas.
Non-Circumferential HALO Treatment:
This treatment is usually given after an initial HALO-360 treatment.
Some people start off with a short segment of Barrett’s oesophagus. This measures less than 3cm in length. These people may not need the HALO-360 treatment. They might start off with just a non-circumferential treatment.
Three different non-circumferential devices are available.
All of these devices do the same thing. They treat small areas of residual Barrett’s oesophagus. The difference between them is simply the size of the area they can treat in one go.
Non-Circumferential HALO Treatment Procedure:
The treatment is very similar to HALO-360:
Follow Up after Non-Circumferential HALO Treatment
Once the treatment is completed, the patient goes home. Another treatment may be offered 2-3 months later. Most people need 3 treatments. Some need more and some need less. At the last treatment, it is usual to treat the junction between with oesophagus and stomach again. This is because abnormalities often recur at this area.
Follow Up After Treatment
It is very important to do a follow up endoscopy to check that all abnormalities have been removed. We recommend taking biopsy samples from the entire area of the original Barrett’s oesophagus.
We cannot guarantee long term success. Long term follow up is therefore important. We currently recommend 3 monthly endoscopies for the first year after successful treatment. In the second year, we recommend 6 monthly endoscopies. After that, we recommend yearly endoscopies long term.
Radiofrequency ablation should be done by experts. We offer this service.If you would like an appointment, please phone 020 7183 7965 or email us on firstname.lastname@example.org Please tell our office staff that you want to see a Barrett’s oesophagus expert. We will make sure you see the right person.