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Randomised controlled trial
Radiofrequency ablation of Barrett's oesophagus with confirmed low-grade dysplasia reduces risk of development of high-grade dysplasia and adenocarcinoma
  1. Christine P J Caygill1,
  2. Piers A C Gatenby1,2
  1. 1UK National Barrett's Oesophagus Registry, Royal Free Campus, University College London, London, UK;
  2. 2Regional Oesophagogastric Unit, Royal Surrey County Hospital, Guildford, UK
  1. Correspondence to : Dr Christine PJ Caygill, UK National Barrett's Oesophagus Registry, Royal Free Campus, University College London, London NW32PF, UK; c.caygill{at}ucl.ac.uk

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Context

The clinical management of patients with suspected low-grade dysplasia in Barrett's oesophagus traditionally involves confirming the diagnosis by repeated systematic biopsy on strong acid suppression therapy and expert histopathological review of the sampled mucosa. Thereafter, patients are offered intensive surveillance with a shorter interval than in non-dysplastic Barrett's oesophagus (due to the increase in risk of development of high-grade dysplasia and adenocarcinoma); however, some patients may also revert to non-dysplastic mucosa.

Endoscopic ablative techniques eradicate the premalignant tissue, thereby obviating the need for potential resection or oncological therapy (and the morbidity, mortality and resource associated with these) with promising short-term outcomes. Long-term outcomes are as yet unknown.

Methods

This is a randomised controlled trial of 136 patients with low-grade dysplasia within Barrett's oesophagus, comparing endoscopic radiofrequency ablation to surveillance alone (randomised …

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