Ablating short-segment Barrett esophagus: What’s your weapon of choice?

August 7th, 2011

Ablating short-segment Barrett esophagus: What’s your weapon of choice?

The first cases of Barrett esophagus (BE) ablation in the late 1980s used YAG and Argon laser. Since then, a myriad of ablation techniques have been described, including multipolar electrocautery (MPEC), argon plasma coagulation (APC), cryotherapy, radiofrequency ablation (RFA), and endoscopic mucosal resection (EMR). Each technique has had its advocates, and some of the techniques appear to have certain advantages in certain types of BE: e.g., long segment, nodular, etc.

Most cases of BE are short segment, and most neoplastic cases do not have nodules or erosions. So the question I would like to see discussed is: In a patient with 1–2 cm of otherwise featureless flat but neoplastic BE:

What ablation technique would you use, and what do you feel makes this technique advantageous?

What would be your second option, and when would you employ it?

Do you use more than one technique, and, if so, which ones do you use and why?

What are the most common complications you see with BE ablation?

What is your overall success at complete BE elimination?

We look forward to your comments.

Categories: Patient care
Tags: Barrett esophagus

You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

Pulsatile Liver in Severe Tricuspid Regurgitation July 25, 2026

A 51-year-old woman with right heart failure presented with worsening abdominal distention and leg swelling. Examination was notable for ascites, leg edema, a grade 4/6 holosystolic murmur, and a pulsatile liver (shown in a video).

Breaking the RAS Barrier in Pancreatic Cancer July 23, 2026

For decades, pancreatic ductal adenocarcinoma (PDAC) has been perhaps the clearest example of a cancer that is driven by a dominant oncogenic event yet is resistant to therapeutic exploitation. More than 90% of pancreatic cancers harbor activating RAS mutations, most commonly those involving KRAS codon 12,...

National Elimination of Hepatitis C — The Case for Starting in Prisons and Jails July 23, 2026

The United States could take meaningful steps toward eliminating hepatitis C by broadly testing and treating people who are involved in the criminal legal system.

Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer July 23, 2026

Among patients with previously treated metastatic pancreatic ductal adenocarcinoma, the RAS(ON) inhibitor daraxonrasib led to significantly longer overall survival and progression-free survival than chemotherapy.

Case 20-2026: A 38-Year-Old Man with Abdominal Pain July 16, 2026

A 38-year-old man was evaluated at the hospital because of postprandial abdominal pain. Six weeks earlier, a diarrheal illness had developed while he was working in Madagascar. A diagnosis was made.

Gut Check on Gastroenterology Archive

Gut Check on Gastroenterology, an NEJM Journal Watch blog focusing on issues in clinical gastroenterology, was active from 2008 to 2014. This archive contains all posts and discussions from Gut Check’s history.

August 7th, 2011