Endoscopic spray cryotherapy: a new technique for mucosal ablation in the esophagus☆,☆☆,★
Section snippets
METHODS
Twenty Yorkshire pigs (2 to 3 months old, 20 kg) were used in this study. On arrival at our facility, the pigs were maintained in conventional holding rooms of an animal facility approved by the American Association for Accreditation of Laboratory Animal Care and were provided tap water ad libitum and commercial swine food. General anesthesia was induced with xylazine/telazol (dose 100 mg xylazine/50 lb, 100 mg telazol/50 lb; route intramuscular). In the first two animals, anesthesia was
RESULTS
A cryoburn appeared in all 20 swine within 10 to 30 seconds of initiating the cryospray. The cryoburn time was the difference between the time when a cryoburn first appeared and the time when the spray was stopped. The cryoburn appeared when the mucosal temperature dropped to between 0° and –10°C. The targeted end point was a cryoburn either in a circumferential or hemicircumferential pattern, not mucosal temperature. Although the temperature of liquid nitrogen is –196°C, freezing occurred at a
DISCUSSION
The present study demonstrates the feasibility and safety of spraying cold nitrogen gas through a catheter via an upper endoscope by means of a simple cryogenic system. This system enables controlled mucosal ablation via freezing much like that achieved with other modalities such as PDT, multipolar electrocoagulation and laser. A 3 cm length of esophagus can be circumferentially sprayed with relative ease in less than 30 seconds. We were able to achieve various degrees of mucosal ablation in
DISCLOSURE STATEMENT
The primary investigator has a patent pending with the U.S. Patent and Trademark Office and has signed an exclusive licensing agreement with FiberTech Medical Inc. of Baltimore, Maryland, for the further development of this device.
DISCLAIMER
The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, the Uniformed Services University of the Health Sciences, the Department of Defense or the United States Government.
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Cited by (0)
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Supported by grant number CO83IH-01 from the Uniformed Services University of the Health Sciences.
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Reprint requests: Mark H. Johnston, MD, FACP, Division of Gastroenterology, National Naval Medical Center, Bethesda, MD 20889.
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