RF ablation of intestinal metaplasia (Barrett esophagus)

摘要

Esophageal intestinal metaplasia, otherwise known as Barrett's esophagus, is a pre-cancerous condition that afflicts over 1 million Americans annually. Barrett's esophagus is caused by chronic esophageal exposure to stomach acid which can occur in patients afflicted with gastro esophageal reflux disease (GERD). The lining of the esophagus undergoes a metaplastic change, from normal squamous cell epithelium to columnar cell epithelium. Over time, this condition can progress to dysplasia and ultimately to adenocarcinoma. Currently, there are no widely practiced therapies for Barrett's esophagus. Patients diagnosed with this disease are routinely screened to ensure do not have cancer, yet it has been shown that if the GERD is controlled (i.e. a normal esophageal pH is maintained) and the metaplastic lining of the esophagus is carefully removed, i.e. no damage to underlying tissues), the normal squamous epithelial cells will repopulate the esophagus. A system has been designed to couple radiofrequency (RF) energy to the epithelial lining of the esophagus to effectively ablate the metaplastic cells and allow normal squamous cell repopulation. The design principles of this system and the resulting effects are the subject of this presentation.