Endoscopic radiofrequency ablation for Barrett's oesophagus with low‑grade dysplasia or no dysplasia

1 Recommendations

1.1 Current evidence on the efficacy of endoscopic radiofrequency ablation for Barrett's oesophagus with low‑grade dysplasia is adequate provided that patients are followed up in the long term. There are no major safety concerns. Therefore, this procedure may be used in patients with Barrett's oesophagus with low‑grade dysplasia with normal arrangements for clinical governance, consent and audit or research.

1.2 Current evidence on the efficacy and safety of endoscopic radiofrequency ablation for Barrett's oesophagus with no dysplasia is limited in quality and quantity. Therefore, this procedure should only be used in patients with no dysplasia in the context of research.

1.3 Patient selection for endoscopic radiofrequency ablation for Barrett's oesophagus with low‑grade dysplasia should be done by a multidisciplinary team experienced in managing Barrett's oesophagus, as described in the British Society of Gastroenterology guidelines.

1.4 Endoscopic radiofrequency ablation for Barrett's oesophagus with low‑grade dysplasia should only be done by endoscopists experienced in treating Barrett's oesophagus, as described in the British Society of Gastroenterology guidelines.

1.5 Clinicians should enter details of all patients undergoing endoscopic radiofrequency ablation for Barrett's oesophagus with low‑grade dysplasia or no dysplasia onto the UK National HALO Patient Registry, and review clinical outcomes locally.

1.6 NICE encourages further research into endoscopic radiofrequency ablation for Barrett's oesophagus with no dysplasia. Studies should define clearly the policies used for histological diagnosis. Outcomes should include complete resolution of Barrett's oesophagus, change and progression to low‑grade dysplasia, high‑grade dysplasia or cancer. All complications should be reported, particularly development of strictures. Comparative studies against surveillance would be useful.