Radiofrequency ablation of symptomatic cervical inlet patch using a through-the-scope device: a pilot study

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• 作者：Jason Mark Dunn ; PhD ; MRCP¹ ; ² ; ; Guiping Sui ; PhD¹ ; Angela Anggiansah ; PhD¹ ; Terence Wong ; MD ; FRCP¹
• 关键词：APC ; argon plasma coagulation ; CIP ; cervical inlet patch ; CR-CIP ; complete reversal of cervical inlet patch ; PPI ; proton pump inhibitor ; RFA ; radiofrequency ablation ; VAS ; visual analog scale
• 刊名：Gastrointestinal Endoscopy
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：84
• 期：6
• 页码：1022-1026.e2
• 全文大小：741 K

文摘

The cervical inlet patch (CIP) is an area of heterotopic gastric mucosa at the proximal esophagus, which can secrete both acid and mucus. Attributable symptoms include chronic globus sensation and sore throat. Previous studies have demonstrated improvement in symptoms after ablation using argon plasma coagulation. Our aim was to assess a through-the-scope radiofrequency ablation (RFA) catheter for ablation of symptomatic CIP.

Methods

Ten patients with endoscopically and histologically proven CIP and symptoms of globus or sore throat were included in the study. An ablation protocol of 3 ablations at 12 J/cm², without removal of coagulated tissue between ablations, was used. A maximum of 2 RFA sessions, 3 months apart, was allowed. A visual analog score was completed at baseline, 6 weeks (on proton pump inhibitor), 3 months (off proton pump inhibitor), and 12 months after treatment.

Results

Mean patient age was 56 years (±3 years, standard error of the mean), 60% were men, and 80% were white. Barrett’s esophagus was present in 50%. The mean number of CIPs was 2 (range, 1-4) with a median surface area of 2 cm² (range, .5-14). After a median of 2 treatments, 80% achieved complete endoscopic and histologic resolution, with a mean follow-up of 14 months (range, 12-17). Globus, sore throat, and cough significantly improved from baseline (P < .05). No strictures or buried glands were identified.

Conclusions

This prospective pilot study demonstrates that RFA using a through-the-scope device is safe and effective for treating patients with symptomatic CIP. One-year follow-up data suggest the effect is durable.