Original articleClinical endoscopyLong-term remission of nondysplastic Barrett's esophagus after multipolar electrocoagulation ablation: report of 139 patients with 10 years of follow-up

BackgroundAblation of Barrett's esophagus (BE) has been advocated as a method to eliminate the risk of malignant transformation of BE.ObjectiveTo provide longer follow-up and determine safety and efficacy of multipolar ablation for nondysplastic BE.DesignProspective cohort study.SettingGastroenterology Unit at the Policlinica Metropolitana, a tertiary care center in Caracas, Venezuela.PatientsOne hundred sixty-six patients with nondysplastic BE and histologic evidence of intestinal metaplasia.InterventionsPatients 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 MeasurementsMortality, incidence of recurrent BE, incidence of adenocarcinoma in ablated BE, and morbidity associated with multipolar electrocoagulation.ResultsOne 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.LimitationUncontrolled clinical trial.ConclusionsLong-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.