Question provided by:
Dr. Adolfo Parra Blanco
Hospital Universitario Central de Asturias, Oviedo, Spain

In shorter segments of Barrett’s esophagus the ablation should start more distally, it is likely that measurements from proximal areas, which do not require ablation, oblige us to use smaller balloons that those we would select if the measurements had started only in the proximal margin of the BE. Is there still a need to start measuring with the sizing catheter from 12 cm above the gastric folds in shorter segments of Barrett’s esophagus?

Suggestion provided on behalf of the RFA Academia training committee by:
Dr. Jacques Bergman
Dept. of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands

We advise to start sizing 5-6 cm above the most proximal extent of the Barrett segment. The general rule of 12 cm above the gastric folds stems from the US and is too much for all Barrett’s shorter than 5-6 cms (the vast majority), but not enough for long segment Barrett’s (eg. C10M11).