Abstracts from Around the World

Advances in technology have brought the concept of ablation of Barrett's mucosa toward reality. A new technique that uses radiofrequency ablation appears to be safe. This prospective, multicenter, sham-controlled trial randomized 127 patients with dysplastic Barrett's esophagus into groups receiving either radiofrequency ablation or sham procedure. The primary outcome measure was complete eradication of dysplasia and intestinal metaplasia at 12 months. Using an intent-to-treat analysis, complete eradication of dysplasia was shown in 90.5% of those with low grade dysplasia compared to 22.7% of those in the sham control group. In the high-grade dysplasia group, complete eradication occurred in 81% of those in the treated group compared to 19% of those in the control group. Overall, 77% of patients receiving radiofrequency ablation had complete eradication of intestinal metaplasia compared to 2.3% in the control group. Fewer cancers were noted in the treatment group than in the control group (1.2% vs 9.3%). Complications in those receiving ablation included 1 patient with gastrointestinal bleeding and 5 patients (6%) with stricture.