Endoscopic cryotherapy:Indications,techniques,and outcomes involving the gastrointestinal tract  

作　　者：Amaninder Dhaliwal Syed M Saghir Harmeet S Mashiana Annie Braseth Banreet S Dhindsa Daryl Ramai Pushpak Taunk Rene Gomez-Esquivel Aamir Dam Jason Klapman Douglas G Adler 

机构地区：[1]Division of Gastroenterology and Advanced Endoscopy,McLeod Regional Medical Center,Florence,SC 29501,United States [2]Division of Gastroenterology,Creighton University School of Medicine,Omaha,NE 68124,United States [3]Division of Gastroenterology and Hepatology,University of Nebraska Medical Center,Omaha,NE 68198-2000,United States [4]Division of Gastroenterology,University of Iowa,Iowa City,IA 52242-1009,United States [5]Division of Gastroenterology and Hepatology,University of Utah School of Medicine,Salt Lake City,UT 84132,United States [6]Division of Gastroenterology,USF Health,Tampa,FL 33612,United States [7]Division of Gastroenterology and Hepatology,Moffitt Cancer Center,Tampa,FL 33612,United States [8]Gastrointestinal Tumor Program,Moffitt Cancer Center,Tampa,FL 33612,United States [9]Center for Advanced Therapeutic Endoscopy,Porter Adventist Hospital,Center Health,Denver,CO 80210,United States

出　　处：《World Journal of Gastrointestinal Endoscopy》2022年第1期17-28,共12页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：Endoscopic cryotherapy is a technique utilized for the ablation of target tissue within the gastrointestinal tract.A cryotherapy system utilizes the endoscopic application of cryogen such as liquid nitrogen,carbon dioxide or liquid nitrous oxide.This leads to disruption of cell membranes,apoptosis,and thrombosis of local blood vessels within the target tissue.Several trials utilizing cryotherapy for Barrett’s esophagus(BE)with variable dysplasia,gastric antral vascular ectasia(GAVE),esophageal carcinoma,radiation proctitis,and metastatic esophageal carcinomas have shown safety and efficacy.More recently,liquid nitrogen cryotherapy(cryodilation)was shown to be safe and effective for the treatment of a benign esophageal stricture which was refractory to dilations,steroid injections,and stenting.Moreover,liquid nitrogen cryotherapy is associated with less post procedure pain as compared to radiofrequency ablation in BE with comparable ablation rates.In patients with GAVE,cryotherapy was found to be less tedious as compared to argon plasma coagulation.Adverse events from cryotherapy most commonly include chest pain,esophageal strictures,and bleeding.Gastric perforations did occur as well,but less often.In summary,endoscopic cryotherapy is a promising and growing field,which was first demonstrated in BE,but the use now spans for several other disease processes.Larger randomized controlled trials are needed before its role can be established for these different diseases.

关 键 词：CRYOTHERAPY Gastric antral vascular ectasia Barrett’s esophagus Esophageal cancer Palliative therapy 

分 类 号：R57[医药卫生—消化系统]