Radiofrequency ablation for the treatment of gastric dysplasia: a pilot experience in three patients.

Different endoscopic techniques such as endoscopic mucosal resection, endoscopic submucosal dissection, argon-plasma coagulation, and photodynamic therapy have been used in the treatment of gastric dysplasia. Radiofrequency ablation (RFA) has become a recognized tool in the treatment of dysplastic Barrett's esophagus, but its use in gastric dysplasia has not yet been studied. We aim to describe three cases of RFA treatment in patients with persistent dysplastic gastric mucosa confirmed by consensus of two expert gastrointestinal pathologists. In each patient, two catheter-based RFA procedures were performed 8 weeks apart in an outpatient setting. Although each patient reported minor epigastric pain after RFA, there were no major complications such as bleeding, perforation, stricture, or the need for hospitalization. Endoscopic follow-up with extensive biopsy sampling 2, 4, 6, 12, and 18 months after the last RFA revealed negative results for dysplasia in all patients. These results suggest that RFA may be considered in the treatment of gastric dysplasia. The confirmation of these data with a large series can lead to a change in the paradigm of gastric dysplasia management.