The evidence on the safety of endoscopic radiofrequency ablation for gastro-oesophageal reflux disease (GORD) is adequate in the short and medium term but there is uncertainty about longer‑term outcomes. With regard to efficacy, there is evidence of symptomatic relief but objective evidence on reduction of reflux is inconclusive. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake endoscopic radiofrequency ablation for GORD should take the following actions.
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having endoscopic radiofrequency ablation for GORD (see section 7.1).
Future review of the guidance might consider evidence from research that includes objective outcome measures such as oesophageal pH, long‑term follow‑up data, comparison with Nissen fundoplication, information about patient selection and further insight into the mechanism of action of the procedure.