Balloon cryoablation for treating Barrett's oesophagus

Balloon cryoablation for Barrett's oesophagus aims to destroy the abnormal cells lining the oesophagus. Sedation is usually used, which is commonly conscious sedation but may be general anaesthesia. A balloon catheter is inserted through an endoscope, aligned with the abnormal tissue and inflated. Nitrous oxide gas is then sprayed through a radial diffuser head within the balloon, which is aimed at the abnormal tissue. The balloon freezes and the extreme cold destroys the abnormal tissue. The nitrous oxide gas remains fully contained within the balloon, which exits the body through the proximal end of the catheter.

The ablation sequence is repeated until all the abnormal tissue is destroyed. Multiple ablations can be done in 1 session without removing the balloon. Repeat endoscopy is usually scheduled 8 to 12 weeks after the procedure to check whether the abnormal tissue has been destroyed. If any of the tissue is found, retreatment may be considered.

The procedure is usually done in an outpatient setting, but is sometimes done in an inpatient setting. The choice of setting may vary by care provider and patient needs.

Medicines such as a histamine2-‑receptor antagonist or proton pump inhibitor may be recommended for some people having cryoablation. The aim of this medication is to improve the success rate of the procedure. It may also help to lower the chance of Barrett's oesophagus returning in the long term.

The identified evidence all used the C2Cryoballoon Ablation system (PentaxMedical, Redwood City, California, USA).