Comparison of ablative techniques for HGD
| Technique | Eradication of dysplasia (%) | Advantages | Disadvantages |
|---|---|---|---|
| Step-wise radical ER | 97–100 | Accurate diagnosis Low costs | High risk of stenosis Only feasible <5 cm Barret's oesophagus |
| APC | 67–86 | Widely available Low costs | Buried glands Feasible for short segments only |
| PDT | 40–77 | RCT data Treatment of nodular dysplasia | High risk of stricture Buried glands Photosensitivity |
| RFA | 80–98 | RCT data High response rate Low complication rate | High costs Minimal long-term follow-up data |
| Cryotherapy | 68–88 | Good safety profile | No RCT data No long-term follow-up data |
Adapted from Fitzgerald et al,22 with permission.
APC, argon plasma coagulation; ER, endoscopic resection; HGD, high-grade dysplasia; PDT, photodynamic therapy; RCT, randomised controlled trial; RFA, radiofrequency ablation.