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

Background and Aims: 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. Methods: 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. Results: 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. Conclusion: 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.