Hironori Sunakawa1,2, Yusuke Yoda1,3, Nobuyoshi Takeshita3,4, Hiro Hasegawa3,4, Kenji Takashima1,3, Tomohiro Kadota1, Takeo Fujita5, Tetsuo Akimoto2,6, Satoshi Fujii7, Tomonori Yano8,9. 1. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan. 2. Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan. 3. NEXT Medical Device Innovation Center, National Cancer Center Hospital East, Kashiwa, Japan. 4. Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Japan. 5. Division of Esophageal Surgery, National Cancer Center Hospital East, Kashiwa, Japan. 6. Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. 7. Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan. 8. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan. toyano@east.ncc.go.jp. 9. NEXT Medical Device Innovation Center, National Cancer Center Hospital East, Kashiwa, Japan. toyano@east.ncc.go.jp.
Abstract
BACKGROUND: The Cryoballoon focal ablation system (CbFAS) for dysplastic Barrett's esophagus is simple, time-saving and has high therapeutic efficacy. This study aimed to evaluate the technical feasibility and tissue damage with combination therapy of endoscopic resection (ER) and CbFAS in porcine models. METHODS: Three pigs (A, B, and C) were included, and all ER procedures were performed by endoscopic mucosal resection using the Cap method (EMR). Combination therapy for each pig was performed as follows: (a) CbFAS was performed for a post-EMR mucosal defect for Pig A; (b) CbFAS for post-EMR scar for Pig B, and (c) EMR for post-CbFAS scar for Pig C. All pigs were euthanized at 32 days after the initial procedure, and the tissue damage was evaluated. RESULTS: All endoscopic procedures were followed as scheduled. None of the subjects experienced anorexia, rapid weight loss, bleeding, and perforation during the observation period. They were euthanized at 32 days after the initial endoscopic procedure. On histological assessment, there was little difference between the tissue that was treated with CbFAS alone and that treated with CbFAS in combination with ER. CONCLUSION: Combination therapy with ER and CbFAS can be technically feasible, and its outcome was not significantly different from CbFAS alone in terms of tissue damage.
BACKGROUND: The Cryoballoon focal ablation system (CbFAS) for dysplastic Barrett's esophagus is simple, time-saving and has high therapeutic efficacy. This study aimed to evaluate the technical feasibility and tissue damage with combination therapy of endoscopic resection (ER) and CbFAS in porcine models. METHODS: Three pigs (A, B, and C) were included, and all ER procedures were performed by endoscopic mucosal resection using the Cap method (EMR). Combination therapy for each pig was performed as follows: (a) CbFAS was performed for a post-EMR mucosal defect for Pig A; (b) CbFAS for post-EMR scar for Pig B, and (c) EMR for post-CbFAS scar for Pig C. All pigs were euthanized at 32 days after the initial procedure, and the tissue damage was evaluated. RESULTS: All endoscopic procedures were followed as scheduled. None of the subjects experienced anorexia, rapid weight loss, bleeding, and perforation during the observation period. They were euthanized at 32 days after the initial endoscopic procedure. On histological assessment, there was little difference between the tissue that was treated with CbFAS alone and that treated with CbFAS in combination with ER. CONCLUSION: Combination therapy with ER and CbFAS can be technically feasible, and its outcome was not significantly different from CbFAS alone in terms of tissue damage.
Authors: Hannah T Künzli; Dirk W Schölvinck; Sybren L Meijer; Kees A Seldenrijk; Jacques G H M Bergman; Bas L A M Weusten Journal: Endoscopy Date: 2016-12-20 Impact factor: 10.093