본문 바로가기
KERD
논문KCI 등재

Assessment on the Potential Role of Applying Cryoprobe for Tissue Ablation

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류내과학

초록

Background/Aims: Cryotherapy is the therapeutic application for tissue ablation. Clinical applications of cryotherpy such as in pulmonology have increased. Until now, its development in gastroenterology has been insignificant. But, as clinical application such as mucosal ablation on Barrett’s esophagus became possible, various applications have been developed. Therefore, it is important to make standards of tissue injury’s extent in cryotherapy prior to clinical trial. We evaluated the tissue injury according to the application of cryoprobe with a pig model. Methods: Cryoprobe was applied to several different segments of the esophagus and stomach for various lengths of time using various number of probe’s contact in a pig model. After 48 hours, esophagus and stomach were harvested and histological tissue injury was assessed. The extent of tissue injury was decided by the injury of the deepest layer. Results: Endoscopic application of cryoprobe on esophagus and stomach resulted in a dose-dependent injury: esophageal necrosis was limited to the submucosa after 10 seconds of cryotherapy, and extended to involve the transmural necrosis after over 15 seconds. Necrosis on stomach was extended to involve the transmural necrosis after over 20 seconds. Conclusions: Positive relationship was seen between the duration and frequency of cryoprobe application and the extent of tissue injury.

Abstract

Background/Aims: Cryotherapy is the therapeutic application for tissue ablation. Clinical applications of cryotherpy such as in pulmonology have increased. Until now, its development in gastroenterology has been insignificant. But, as clinical application such as mucosal ablation on Barrett’s esophagus became possible, various applications have been developed. Therefore, it is important to make standards of tissue injury’s extent in cryotherapy prior to clinical trial. We evaluated the tissue injury according to the application of cryoprobe with a pig model. Methods: Cryoprobe was applied to several different segments of the esophagus and stomach for various lengths of time using various number of probe’s contact in a pig model. After 48 hours, esophagus and stomach were harvested and histological tissue injury was assessed. The extent of tissue injury was decided by the injury of the deepest layer. Results: Endoscopic application of cryoprobe on esophagus and stomach resulted in a dose-dependent injury: esophageal necrosis was limited to the submucosa after 10 seconds of cryotherapy, and extended to involve the transmural necrosis after over 15 seconds. Necrosis on stomach was extended to involve the transmural necrosis after over 20 seconds. Conclusions: Positive relationship was seen between the duration and frequency of cryoprobe application and the extent of tissue injury.

참고문헌 (15)

  1. American Society for Gastrointesstinal Endoscopy Technology Committee, "Mucosal ablation devices", Gastrointest Endosc, 68, pp.1031~1042 (2008)
  2. Sguazzi A, "A historical account of the technical means used in cryotherapy", Minerva Med, 65, pp.3718~3722 (1974)
  3. Cooper IS, "Cryobiology as viewed by the surgeon", Cryobiology, 51, pp.44~51 (1964)
  4. Shaheen NJ, "Safety and efficacy of endoscopic spray cryotherapy for Barrett’s esophagus with high-grade dysplasia", Gastrointest Endosc, 71, pp.680~685 (2010)
  5. Kantsevoy SV, "Endoscopic cryotherapy for the treatment of bleeding mucosal vascular lesions of the GI tract: a pilot study", Gastrointest Endosc, 57, pp.403~406 (2003)
  6. Kaouk JH, "Cryotherapy: clinical end points and their experimental foundations", Urology, 68(1 Suppl), pp.38~44 (2006)
  7. Franke KJ, "Experimental study on biopsy sampling using new flexible cryoprobes: influence of activation time, probe size, tissue consistency, and contact pressure of the probe on the size of the biopsy specimen", Lung, 187, pp.253~259 (2009)
  8. Maiwand MO, "Cryotherapy for tracheobronchial disorders", Clin Chest Med, 16, pp.427~443 (1995)
  9. Raju GS, "Graded esophageal mucosal ablation with cryotherapy, and the protective effects of submucosal saline", Endoscopy, 37, pp.523~526 (2005)
  10. Chino A, "A comparison of depth of tissue injury caused by different modes of electrosurgical current in a pig colon model", Gastrointest Endosc, 59, pp.374~379 (2004)
  11. Gage AA, "Mechanisms of tissue injury in cryosurgery", Cryobiology, 37, pp.171~186 (1998)
  12. Sheski FD, "Cryotherapy, electrocautery, and brachytherapy", Clin Chest Med, 20, pp.123~138 (1999)
  13. Whittaker DK, "Repeat freeze cycles in cryosurgery of oral tissues", Br Dent J, 139, pp.459~465 (1975)
  14. Rubinsky B, "A cryomicroscope using directional solidification for the controlled freezing of biological material", Cryobiology, 22, pp.55~68 (1985)
  15. Pasricha PJ, "Endoscopic cryotherapy: experimental results and first clinical use", Gastrointest Endosc, 49, pp.627~631 (1999)

관련 논문AI추천

Novel Ablation Therapy Using Endoscopic Irreversible Electroporation in the Bile Duct: A Pilot Animal Study금보라, 김창덕, 엄순호, 오치혁, 이홍식, 전훈재, Eun Sun Kim, Hong Bae Kim, Hyuk Soon Choi, Jae Min Lee, Kang Won Lee, Yeon Seok Seo, Yoon Tae Jeen대한소화기내시경학회 · Clinical Endoscopy2021 · 제54권 제3호Evaluation of cryoablation using a prototype cryoablation needle in swine liverDaejin Kim, Dong Uk Kim, Gun-Ho Kim, Hyunjoon Son, Jonghyun Lee, Sung Yong Han, Tae In Kim대한소화기내시경학회 · Clinical Endoscopy2024 · 제57권 제5호Cryotherapy versus radiofrequency ablation in the treatment of dysplastic Barrett’s esophagus with or without early esophageal neoplasia: a systematic review and meta-analysisAlexandre de Sousa Carlos, Beanie Conceição Medeiros Nunes, Bruno Salomão Hirsch, Diogo Turiani Hourneaux de Moura, Eduardo Guimarães Hourneaux de Moura, Guilherme Henrique Peixoto de Oliveira, Igor Braga Ribeiro, Igor Logetto Caetité Gomes, Roberto Paolo Trasolini, Sérgio Barbosa Marques, Wanderley Marques Bernardo대한소화기내시경학회 · Clinical Endoscopy2024 · 제57권 제2호Submucosal Injection of Normal Saline can Prevent Unexpected Deep Thermal Injury of Argon Plasma Coagulation in the in vivo Porcine StomachMitsuhiro Fujishiro거트앤리버 소화기연관학회협의회 · Gut and Liver2008 · 제2권 제2호Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection?Bong Min Ko, Gwang Ho Baik, Hee Seok Moon, In Kyung Yoo, Jae-Young Jang, Jin Seok Jang, Joo Young Cho, Seong Hwan Kim, Sun Gyo Lim, Wan-Sik Lee, Weon Jin Ko, Young Kwan Cho, Yunho Jung대한소화기내시경학회 · Clinical Endoscopy2021 · 제54권 제4호Efficacy of an assistive guide tube for improved endoscopic access to gastrointestinal lesions: an in vivo study in a porcine model김상균, Dong Seok Lee, Hyoun Woo Kang, Jeong-Sik Byeon, Ji Bong Jeong, Ji Won Kim, Kook Lae Lee, Yong Jin Jung대한소화기내시경학회 · Clinical Endoscopy2024 · 제57권 제1호

이 간행물의 다른 논문 (7건)