Radiofrequency Ablation (RFA)
Radiofrequency Ablation (RFA) is a minimally invasive procedure treating dysplastic (precancerous) Barrett's esophagus. Barrett’s esophagus is a complication that can occur from having chronic acid reflux, also known as gastroesophageal reflux disease (GERD). Acid reflux occurs when stomach acid backs up into your esophagus. This frequently results in heartburn and can occasionally cause damage to the lining of the esophagus.
This damage can lead to esophageal cancer, one of the deadliest forms of cancer, which has only a 38 percent five-year survival rate for cancer that is localized, meaning it is only growing in the esophagus. RFA provides a less invasive option than traditional surgery by removing precancerous cells and potentially greatly improving a patient's outcome.
What Happens During Radiofrequency Ablation?
During RFA, the inner lining of the esophagus containing the precancerous cells is removed by the application of high radiofrequency waves. These waves are applied by a set of electromagnetic coils that are attached to a balloon. The balloon is placed in the esophagus during an endoscopy. Based upon the spacing of the coils and the amount of energy that is flowing through them, doctors can consistently and reliably remove the needed depth of esophageal lining to remove the precancerous cells.
The procedure is fairly short, taking an average of 25 to 50 minutes.
What are the Outcomes with Radiofrequency Ablation?
Recent studies have shown that, five years after undergoing RFA, 92 percent of patients were free of Barrett’s esophagus. Currently, most doctors continue to perform endoscopic biopsy surveillance in patients who have undergone RFA, but this practice may diminish as more patients have this procedure.
Preparing for Radiofrequency Ablation
Your physician will provide you with specific pre-procedure instructions that you must follow. Prior to RFA, you may be asked to alter the type or dosing of certain medications you are taking. As for most procedures, you will be asked not to eat or drink anything after midnight the night before the procedure.
It is important that your acid reflux be well-controlled before, during, and after RFA. So, your physician might increase or change the medications you are currently taking to manage your acid reflex.
What Happens After Radiofrequency Ablation?
Immediately following RFA, you will spend some time resting in recovery while the sedation medication wears off. RFA is performed as an outpatient procedure, so you can have your procedure in an ambulatory surgery center, which can provide better accessibility and ease compared to a hospital. You will need to consult with your doctor concerning the starting or continuation of medications following your procedure. Recovery time varies by patient with most reporting mild discomfort lasting 2 to 4 days. Most patients can return to their normal, daily activities during this recovery time.