Ablative Therapy for Esophageal Dysplasia and Early Malignancy: Focus on RFA

Table 1

Ablative techniques.

Esophageal ablative technique	Method	Frequency of treatment	Complete eradication of intestinal metaplasia	Complete eradication of low grade dysplasia	Complete eradication of high grade dysplasia	Common complications (%)
RFA^1	Endoscopic balloon creates high frequency current which causes topical destruction of tissues	q2-3 months until resolution	54–97%	80–100%	81–90%	Stricture (2–6%), hemorrhage
PDT^2	Photosensitizer given prior to procedure allows the application of a specific wavelength of light to cause creation of oxygen free radicals and topical destruction of tissues	1-2 treatments, often followed by Nd:Yag laser therapy	52%	93%	77%	Photosensitivity, Stricture (30%)
APC^3	Argon gas is passed through endoscope, monopolar current conducts through gas, and resulting heat causes topical destruction of tissues	q8 week treatments	0–55%	—	76%	Stricture (15%)
Cryotherapy^4	Topical application of coolants causes destruction of tissues	3–5 treatments	57–84%	87%	97%	Stricture (9%)

Description of common ablative techniques ¹[28–31] ²[16, 17] ³[23, 26, 32, 33] ⁴[34–36].