Endoscopic cryotherapy: experimental results and first clinical use

Pasricha, Pankaj J.; Hill, Susan L.; Wadwa, Kalyan S.; Gislason, Gunnar; Okolo, Patrick I.; Magee, Carolyn; Canto, Marcia Irene; Kuo, Wu-Hsien; Baust, John G.; Kalloo, Anthony N.

doi:10.1016/s0016-5107(99)70393-7

Cited by 83 publications

(43 citation statements)

References 6 publications

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“…Indeed, only a few small-sized case-series have been reported [73][74][75] . Thus, cryoablation might not be considered as a feasible alternative to other established endoscopic treatments.…”

Section: Cryoablationmentioning

confidence: 99%

Pelvic radiation disease: Updates on treatment options

Frazzoni

Marca

Guido

et al. 2015

WJCO

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Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiationtreated patients say that their quality of life is affected by GI symptoms (e.g. , rectal bleeding, diarrhoea). The constellation of GI symptoms -from transient to longterm, from mild to very severe -experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e. , medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e. , causing chronic anemia) should firstly be considered for medical management (i.e. , sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments.

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Section: Cryoablationmentioning

confidence: 99%

Pelvic radiation disease: Updates on treatment options

Frazzoni

Marca

Guido

et al. 2015

WJCO

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“…The first description of spray cryotherapy (SCT) was initially described using liquid nitrogen spray in 1997 by Pasricha et al in a canine esophageal model (9). Later in 1999 Johnston et al also described the endoscopic SCT system in a porcine model to examine its effects on the esophagus.…”

Section: Brief History Of Cryotherapymentioning

confidence: 99%

Current status of spray cryotherapy for airway disease

Moore¹,

Lile²,

Abbas³

2017

J. Thorac. Dis.

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The use of liquid nitrogen to treat skin and mucosal lesions is well understood in the dermatologic and gastrointestinal literature. Direct spray cryotherapy (SCT) in the airway has shown promising results in the treatment of esophageal premalignant and even invasive lesions. In the airway, several studies have shown it to be a safe, effective treatment for both benign and malignant disease. It is easily administered in the outpatient setting and can be repeated several times without undue side effects. In this article, we review the current literature on the use of SCT for the treatment of endobronchial lesions and also describe our own institutional experience of the use of SCT in the airway. The use of proper technique and airway venting is important in mitigating the complications of barotrauma from massive expansion of nitrogen upon conversion from the liquid to gaseous state. We also review some of the basic science principals behind the use of the cryotherapy to treat lesions in different tissues. We feel that SCT is a potential area for further research at both clinical and basic science level.

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“…80 However, recent delivery of new liquid nitrogen or nitrous oxide delivery systems has made endoscopic cryotherapy feasible although still experimental. [81][82][83] Cryotherapy using nitrous oxide relies on the Joule-Thompson effect: rapid expansion of compressed gas results in a drop in temperature of the gas. The resultant "no contact" therapy has been tested in proctitis and may also be possible in upper gastrointestinal lesions.…”

Section: Future Directions In Endoscopymentioning

confidence: 99%

Nonvariceal Upper Gastrointestinal Bleeding

Ferguson

Mitchell²

2004

Endoscopy

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A study in the Netherlands examined recent time trends in the incidence and outcome of upper gastrointestinal bleeding between the periods 1993-94 and 2000 [1]. The incidence of acute upper gastrointestinal bleeding decreased from 61.7 per 100 000 in 1993-94 to 47.7 per 100 000 persons annually in 2000, corresponding to a 23 % decrease in the incidence after age adjustment (95 % CI, 15 % to 30 %). Despite more frequent use of combination treatment, more frequent endoscopic interventions to treat ulcers with adherent clots, and a higher rate of protonpump inhibitor (PPI) use in the second period, the rebleeding rate (16 % vs. 15 %) and mortality rate (14 % vs. 13 %) did not differ between the two periods. Ulcer bleeding remained the most frequent cause of bleeding, at 40 % (1993-94) and 46 % (2000). Almost half of all patients with peptic ulcer bleeding were using nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin. Re-bleeding was similarly high among patients with peptic ulcer bleeding in both groups (20 % and 22 %, respectively). Increasing age, presence of severe comorbidities, and rebleeding were associated with higher mortality. An analysis of secular trends in hospitalization and mortality rates from peptic ulcer disease, upper gastrointestinal bleeding, and any gastrointestinal bleeding was published using data from the National Hospital Discharge Survey [2]. These rates were compared with sales of NSAIDs, aspirin, and acid-suppression medications from 1992 to 1999. Annual rates of hospitalization and mortality per 100 000 population for peptic ulcer disease declined from 205 to 165 and 7.7 to 6.0, respectively; the calendar year correlated negatively with both peptic ulcer disease hospitalization rates (P = 0.007) and mortality rates (P = 0.058). Sales of acid-suppression medications correlated negatively with peptic ulcer disease hospitalization rates (P = 0.037) and mortal

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Endoscopic cryotherapy: experimental results and first clinical use

Cited by 83 publications

References 6 publications

Pelvic radiation disease: Updates on treatment options

Pelvic radiation disease: Updates on treatment options

Current status of spray cryotherapy for airway disease

Nonvariceal Upper Gastrointestinal Bleeding

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