Digest
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With the rising incidence of adenocarcinoma of the oesophagus, a method of eliminating Barretts oesophagus would be a step forward. The authors randomised 35 patients with Barretts oesophagus to ablative treatment with either multipolar electrocoagulation or argon beam coagulation. The good news is that both treatments eliminated Barretts oesophagus at 2 years in approximately 70% of patients, with neither treatment showing any statistical advantage over the other. Adverse events and outcomes were rare. Unfortunately it was not possible to identify risk factors for treatment failure. The bad news is that ablative treatment does not eliminate the need for surveillance as ablation is incomplete in 30% of patients. Repeated biopsies are required of the previous Barretts area to identify these treatment failures. Furthermore, it is still unknown whether such ablative treatment reduces the risk of subsequent adenocarcinoma. The authors conclude ablative treatment is not yet ready for clinical practice except as
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