Radiofrequency Ablation as an Alternative and Novel Procedure in the Intraepithelial Neoplasia Management: A Systematic Scoping Review

TL;DR

This review explores radiofrequency ablation as a minimally invasive treatment for different types of intraepithelial neoplasia, showing promise in esophageal, gastric, anal, and cervical cases.

Contribution

The study systematically evaluates radiofrequency ablation's role in managing various intraepithelial neoplasia types, highlighting its potential as a minimally invasive alternative.

Findings

Radiofrequency ablation is effective for esophageal, gastric, anal, and cervical intraepithelial neoplasia.

Combination therapy with RFA and endoscopic mucosal resection improves outcomes in Barrett's esophagus.

RFA is suitable for low-grade gastric dysplasia but not high-grade cases.

Abstract

Radiofrequency ablation (RFA) has emerged as a promising minimally invasive technique for eliminating intraepithelial neoplasia (IEN). We reviewed current evidence investigating the role of RFA in managing different types of IEN.

A systematic review was conducted to assess the current evidence for the use of RFA in managing various types of IEN. A three‐step search strategy was employed, involving keyword extraction, comprehensive database searching (PubMed, Scopus, Web of Science, Embase, and Google Scholar), and reference screening.

Thirty‐two articles were included in this review, and most of the literature reported the features of RFA in the esophagus‐related IENs (68.7%). RFA treatment was also found to effectively address gastric (9.3%), anal (12.5%), and cervical (9.3%) IENs. The general opinion on using RFA in Barrett's esophagus (BE) was its combination therapy with the endoscopic mucosal resection (EMR) methods, which suggested better outcomes than RFA/EMR monotherapy. RFA was not preferred treatment for high‐grade gastric dysplasia, but it was effective for the low‐grade type.

As a minimally invasive, safe, and effective procedure, RFA holds promise for addressing lesions associated with BE, gastric, anal, and cervical IEN; However, the scope and gaps related to RFA therapy require to be explored precisely.

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