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Endoscopic cryotherapy: experimental results and first clinical use
P J Pasricha1, S Hill, K S Wadwa
1Division of Gastroenterology and Hepatology, University of Texas Medical Branch, Galveston, Texas 77555-0764, USA.
Gastrointestinal Endoscopy
|May 6, 1999
Summary
Endoscopic cryotherapy, using a novel device, shows promise for gastroenterology applications like tissue ablation and tumor debulking. This preliminary study demonstrates feasibility for various gastrointestinal conditions.
Area of Science:
- Gastroenterology
- Medical Devices
- Cryosurgery
Background:
- Cryotherapy, or extreme cold application, has potential in gastroenterology for tissue destruction and hemostasis.
- Development has been hindered by the absence of an endoscopic delivery device.
- This study explores prototype devices using liquid nitrogen and cryogenic refrigerants.
Observation:
- Cryotherapy was applied to canine esophageal mucosa and bleeding ulcer models.
- The procedure was also used for palliative care in a patient with gastric adenocarcinoma.
- Histologic evaluation in dogs showed superficial epithelial necrosis followed by regeneration.
Findings:
- Endoscopic cryotherapy achieved instantaneous superficial mucosa freezing in dogs.
- Hemostasis was achieved temporarily in bleeding ulcer models.
- The patient with gastric adenocarcinoma experienced pyloric mass reduction with no immediate adverse effects.
Implications:
- Preliminary data suggest endoscopic cryotherapy is feasible with a simple hand-held device.
- Potential applications include ablation of superficial epithelium, debulking tumors, and hemostasis in gastroenterology.
- Further research is warranted to explore the full therapeutic potential.